ABSTRACT
OBJECTIVE: To determine the contribution of ultrasonography in the diagnosis of abdominal tuberculosis (TB) in HIV- infected children at the University TeachingHospital Sourô-Sanou of Bobo-Dioulasso, Burkina Faso. METHODS: In children infected with HIV and suspected to develop tuberculosis (TB) on the basis of epidemiological and clinical evidence, the following were performed at inclusion, at 2, 6, and 9 months of follow-up: a chest x-ray and abdominal ultrasound. A bacteriological investigation of the Koch bacillus (BK) was made. All children diagnosed with TB were put on treatment. RESULTS: Sixty-three (63) children with suspected TB were included. Thirty one children (42.86%) had been diagnosed with tuberculosis. Tuberculosis with abdominal lesions accounted for 29.03% (9/31) of TB cases, divided as follows: 4 cases (12.9%) of abdominal tuberculosis without radiographic lung lesions; 5 (16.13%) cases of multifocal TB associating pulmonary involvement with ultrasound abdominal lesions. Bacteriological confirmation was 55.55%. The main ultrasound lesions were abdominal lymph nodes (88.89%). A spleen miliary and hepatosplenic miliary were noted in 33.33% and 11.11% of the cases respectively. The evolution under antituberculous treatment was favorable in 88.88% of the cases. CONCLUSION: Ultrasonography is a significant contributor in the diagnosis and monitoring of treatment of abdominal TB in HIV-infected children.
OBJECTIF: Déterminer l'apport de l'échographie dans le diagnostic de la tuberculose (TB) abdominale chez l'enfant infecté par le VIH au Centre Hospitalier Universitaire Sourô-Sanou de Bobo-Dioulasso, Burkina Faso. MÉTHODE: Chez des enfants infectés par le VIH et suspects de développer une TB sur la base d'arguments épidémiologiques et cliniques, étaient réalisées une radiographie pulmonaire et une échographie abdominale à l'inclusion, à 2, 6, et 9 mois de suivi. Une recherche bactériologique du bacille de Koch (BK) était effectuée. Les enfants dépistés tuberculeux étaient mis sous traitement. RÉSULTATS: 63 enfants suspects de TB étaient inclus. Trente un (42,86%) étaient diagnostiqués tuberculeux. La TB avec lésions abdominales était de 29,03% (9/31), répartie en 4 cas de tuberculose abdominale sans lésions radiographiques pulmonaires, 5 cas associant une atteinte pulmonaire et les lésions abdominales échographiques. La confirmation bactériologique était de 55,55%. Les principales lésions échographiques étaient des adénopathies profondes (88,89%). Une miliaire splénique et hépatosplénique était notée dans 33,33% et 11,11% des cas respectivement. L'évolution sous traitement antituberculeux était favorable dans 88,88% des cas. CONCLUSION: l'échographie est d'un apport majeur dans le diagnostic et le suivi du traitement de la TB abdominale chez l'enfant infecté par le VIH.
ABSTRACT
Viral hepatitis B is a public health issue. We establish the children serological profile of hepatitis B in Bobo-Dioulasso, six years after the introduction of hepatitis B vaccine into the Expanded Program on Immunization. This was a descriptive study of prospective data collection carried out in the Department of Pediatrics and the laboratory of virology of the Centre MURAZ of Bobo-Dioulasso between March 2013 and May 2013. Blood samples were made in search of the following hepatitis B serological markers: anti-HBcAb total, HBsAg, Ac anti-HBs, HBeAg, AcHBs, IgM anti-HBc total. The ELISA method with the Monolisa BIORAD reagents was used. A total of 2015 children were included, 1026 (50, 9%) boys and 989 (49.1%) girls, at an average age of 58±48 months. Out of these 2015 children, 53 (2.6%) were positive to HBsAg including 19 vaccinated cases, one child has received 3 doses plus 1 booster dose of hepatitis B vaccine. We found no statistically significant difference in the carriage of serologic markers of hepatitis B between the unvaccinated group and the vaccinated group. Large-scale studies should be carried out in Burkina Faso to see the real impact of vaccination on the health of our populations.
