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1.
Afr. pop.stud ; 33(1): 4598-4610, 2019.
Article in French | AIM (Africa) | ID: biblio-1258271

ABSTRACT

Objectif : Décrire le profil des groupes spécifiques de femmes qui portent le plus lourd fardeau des besoins non satisfaits en planification familiale. Méthodologie : Analyse secondaire des données de l'EDS 2012 portant sur les besoins non satisfaits de PF chez les femmes en âge de procréer, sexuellement actives et exposées aux grossesses. Chi 2 de Pearson et Ttest de Student réalisés. Analyse multivariée par technique CHAID de l'arbre de décision. Interprétation des résultats au seuil (α=5%, IC à 95%). Résultats : les BNSPF de l'ordre de 50 à 58% sont portées par moins de 4% de la population féminine. Plus de 21% ont des BNSPF de l'ordre de 32 à 39% et sont majoritairement sans instruction, multipares, venant du Centre et du Sud du pays. Conclusion : Développer des stratégies desensibilisation et de communication spécifiquement adaptés à ces groupes pour combler le gap d'utilisation des méthodes contraceptives


Subject(s)
Cote d'Ivoire , Family Planning Services
3.
Mali méd. (En ligne) ; 25(1): 61-63, 2010.
Article in French | AIM (Africa) | ID: biblio-1265623

ABSTRACT

Les mycoses sont une cause peu commune de pneumopathie. Dans certaines circonstances favorables; elles peuvent etre a l'origine de tableaux cliniques et radiologiques trompeurs; pouvant faire errer le diagnostic


Subject(s)
Pneumonia, Bacterial
4.
Rev Pneumol Clin ; 63(5 Pt 1): 301-3, 2007 Oct.
Article in French | MEDLINE | ID: mdl-18166932

ABSTRACT

Clinical, radiographic, biological, histological and pathological data from thirty HIV-infected patients with tuberculous pleural effusion were prospectively collected at the pulmonary disease clinic at the University teaching hospital of Treichville in Abidjan from April to December 1999. Patients mean age was 35 years, ranging from 16 to 79. The white cell count in the serous effusion pleural fluid was high with predominant lymphocytes. Microscopy examination of the aspirate did not show AFB. The Tuberculin Skin Test remained negative for 16 patients (53%). Multiple pleural biopsies showed typical tuberculous follicles in 19 patients (63%) and a non-typical inflammatory reactions in eleven patients (37%).


Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , HIV Infections/epidemiology , Pleural Effusion/epidemiology , Tuberculosis, Pleural/epidemiology , Adolescent , Adult , Age Factors , Aged , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Cote d'Ivoire/epidemiology , Drug Therapy, Combination , Female , HIV Infections/diagnosis , Humans , Male , Middle Aged , Pleural Effusion/diagnosis , Prevalence , Prospective Studies , Sex Factors , Time Factors , Tuberculosis, Pleural/diagnosis , Tuberculosis, Pleural/drug therapy
5.
Bull Soc Pathol Exot ; 99(1): 15-6, 2006 Mar.
Article in French | MEDLINE | ID: mdl-16568675

ABSTRACT

From December 1995 to March 1996 a cross sectional study was carried out in the pulmonary Medicine Unit of Treichville in Abidjan. In order to specify the main aetiologies of pleural effusion, an investigation was conducted among 35 adult patients (19 men and 16 women) suffering from pleuritis. Overall, the mean age was 32.2 years (range: 19-53 years). All the patients underwent a standard chest x-ray a skin test with 10 units of tuberculin, a whole blood cells count with CD4 T cells count and HIV test. The following analysis were performed on the pleural fluid for all patients: cytological, bacteriological and mycobacteriological examination. Some patients underwent as well a pleural biopsy performed by Abram's needle. Pleural fluid was clear in 24 cases (69%). Empyema was found in 8 cases (23%) and hemorrhagic fluid in 3 cases (9%). Tuberculosis was the dominant aetiology of pleuritis noted in 29 patients (83%), followed by far by non-tuberculous bacterial infections in 6 patients (17%). Tuberculosis associated with common bacterial infections was noted in 3 cases.


Subject(s)
HIV Infections/complications , Pleural Effusion/etiology , Adult , Cote d'Ivoire , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prospective Studies
6.
Bull Soc Pathol Exot ; 98(2): 87-8, 2005 Jun.
Article in French | MEDLINE | ID: mdl-16050370

ABSTRACT

A cohort study was carried out from October 2001 to March 2002, in order to analyze the main characteristics of 53 adults patients (38 HIV-positive and 15 HIV-negative), who had a relapse of pulmonary tuberculosis. The observance in the first period of the treatment of tuberculosis was regular in 79% of tuberculous patients infected by the HIV (30/38) and in 87% of tuberculous patients who where HIV-negative (13/15) (p = 0.7). The relapse occurred before one year after recovery in 74% among the HIV-positive (28/38) and in 33% among the HIV-negative patients (5/15) (p = 0.00). Most of the HIV-positive patients (74%) had CD4 counts under 200/mm3 and 80% of the HIV-negative patients had more than 500 CD4 counts/mm3 (p = 0.00). After two months of retreatment following the relapse diagnosis, the rate of improvement in patients was about 16% in HIV infected (6/38) and about 67% in HIV-negative patients (10/15) (p = 0.00).


Subject(s)
HIV Infections/complications , Tuberculosis, Pulmonary/complications , Adolescent , Adult , CD4 Lymphocyte Count , Cote d'Ivoire , Female , Humans , Male , Middle Aged , Recurrence
7.
Bull Soc Pathol Exot ; 96(1): 39-40, 2003 Mar.
Article in French | MEDLINE | ID: mdl-12784592

ABSTRACT

A retrospective study from 1989 to 1993 was carried out on eighty patients out of 106 cases of tuberculosis treatment failure; representing 2.2% of persons with active pulmonary tuberculosis followed at the tuberculosis screening center of Abidjan. The rate of HIV seropositivity was 43.7%. At the beginning of the therapy, 80% of HIV-positive and 89% of HIV-negative had diffuse pulmonary lesions (no significant difference: P > 0.05. At the end of second month therapy, 49% of co-infected and 51% of HIV-negative patients showed bacteriological negative sputum. The treatment administered after reporting failure, led to 63% of recovery among the HIV-positive (22/35) and 62% among the HIV-negative (28/45). On the other hand, the rate of patients out of touch was high in both populations; respectively 29% of HIV infected and 31% of HIV-negative spreading the risk of contamination of neighbourhood by probably resistant bacilli.


Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antitubercular Agents/therapeutic use , Tuberculosis, Pulmonary/drug therapy , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/microbiology , Adolescent , Adult , Aged , Cote d'Ivoire/epidemiology , Female , HIV Seronegativity , HIV Seroprevalence , Humans , Male , Mass Screening , Middle Aged , Retrospective Studies , Risk Factors , Sputum/microbiology , Treatment Failure , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/microbiology
8.
Trans R Soc Trop Med Hyg ; 96(5): 521-8, 2002.
Article in English | MEDLINE | ID: mdl-12474480

ABSTRACT

Entamoeba histolytica has been separated in recent years into 2 morphologically identical species: the apathogenic E. dispar and the pathogenic E. histolytica, only the latter being pathogenic. Although various laboratory techniques allow discrimination between the 2 species there is a lack of field data about the suitability of available diagnostic tests for use in epidemiological studies and few epidemiological studies using species-specific diagnosis have been performed at community level in endemic areas, especially in sub-Saharan Africa. We conducted a repeated cross-sectional study of 967 schoolchildren in central Côte d'Ivoire to compare and evaluate light microscopy, 2 different antigen detection assays, and one polymerase chain reaction (PCR) assay. Microscopy and a non-specific antigen capture Entamoeba enzyme-linked immunosorbent assay (ELISA) were used for the primary screening of all children (time t0). The prevalence of the E. histolytica/E. dispar species complex at t0 was 18.8% by single microscopical examination and 31.4% using the non-specific ELISA. Approximately 2 months after the initial screening, fresh stool specimens were collected on 2 consecutive days (t1 and t2) from (i) all the children who were positive by microscopy at t0 (n = 182) and (ii) 155 randomly selected children who were negative at the primary screening. These samples were tested with a second antigen detection ELISA specific for E. histolytica (n = 238) and with a species-specific PCR assay (n = 193). The second and third examinations (t1 and t2) revealed an additional 43 infections with the species complex E. histolytica/E. dispar, so that the cumulative microscopical prevalence for t1 and t2 was 27.7%. The overall prevalence of E. histolytica by species-specific ELISA antigen detection was low (0.83%), while the prevalence of E. dispar was 15%. When analysing only microscopically positive samples by PCR (n = 129), the ratio E. histolytica: E. dispar was very low (1:46), suggesting that the vast majority of Entamoeba infections in this area were apathogenic. Both species-specific tests performed well but the ELISA was easier to use for large-scale field screening.


Subject(s)
Entamoebiasis/parasitology , Adolescent , Animals , Anthelmintics/therapeutic use , Child , Cote d'Ivoire/epidemiology , Cross-Sectional Studies , Entamoeba , Entamoeba histolytica , Entamoebiasis/drug therapy , Entamoebiasis/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Giardiasis/drug therapy , Humans , Male , Metronidazole/therapeutic use , Polymerase Chain Reaction , Praziquantel/therapeutic use , Prevalence , Schistosomiasis mansoni/drug therapy , Species Specificity
9.
Rev Pneumol Clin ; 58(5 Pt 1): 277-81, 2002 Nov.
Article in French | MEDLINE | ID: mdl-12486377

ABSTRACT

The aim of this retrospective study was to evaluate the yield of bronchial endoscopy for the diagnosis of tuberculous mediastinal adenopathies. We analyzed the results in 200 procedures in patients with tuberculous mediastinal adenopathies. Mediastinal tuberculous adenopathies were found in 6% of the patients with tuberculosis diagnosed during the same period. Mean age of the patients was 30.5 years, and the sex ratio was 1.5. Bronchial endoscopy improved the diagnostic yield of the bronchial aspiration fluid (22% versus 11% without endoscopy). This method allowed positive diagnosis of tuberculosis in 164 patients (82%) by visualizing specific lesions such as compressions, granulations, and gangliobronchial fistulae. Histological confirmation was obtained in 72 (79%) patients among 91 biopsy specimens. Bronchial endoscopy remains a crucial exploration for the diagnosis of mediastinal tuberculous adenopathy, even in HIV-infected patients, because in our series, among 101 treated patients, 99 were HIV positive (98%).


Subject(s)
Bronchoscopy/methods , Mediastinal Diseases/pathology , Tuberculosis, Lymph Node/pathology , Adolescent , Adult , Aged , Biopsy , Female , Humans , Male , Middle Aged , Retrospective Studies , Sensitivity and Specificity
10.
Rev Mal Respir ; 17(2): 477-80, 2000 Apr.
Article in French | MEDLINE | ID: mdl-10859766

ABSTRACT

Percentages of primary and acquired resistance to anti-tuberculosis drugs provide an epidemiological indicator useful for assessing national anti-tuberculosis programs. Rifampicin and isoniazide are widely used in countries with a high prevalence of tuberculosis. In tropical Africa, these drugs are the mainstay treatment for tuberculosis, used both in the initial and long-term regimens. Simultaneous resistance to these two antibiotics would seriously jeopardize therapeutic efficacy. We studied simultaneous rifampicin and isoniazide resistance in patients hospitalized for tuberculosis in the respiratory disease unit of the Treichville University hospital in Abidjan, Ivory Coast. Mycobacterium tuberculosis was isolated in 8 patients. All the strains isolated were resistant to streptomycin. History taking revealed that resistance was observed at the initial prescription in 6 cases. A notion of contagion was present in 4 cases. Six patients were HIV-positive. Surveillance of resistance to anti-tuberculosis drugs is helpful in detecting early changes which could compromise the efficacy of the therapeutic scheme.


Subject(s)
Antibiotics, Antitubercular/therapeutic use , Antitubercular Agents/therapeutic use , Isoniazid/therapeutic use , Rifampin/therapeutic use , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Pulmonary/drug therapy , AIDS-Related Opportunistic Infections/drug therapy , Adolescent , Adult , Cote d'Ivoire , Ethambutol/therapeutic use , Female , Humans , Male , Medical History Taking , Mycobacterium tuberculosis/drug effects , Streptomycin/therapeutic use
11.
Int J Tuberc Lung Dis ; 4(4): 321-6, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10777080

ABSTRACT

SETTING: Tuberculin skin test (TST) survey of health care workers (HCWs) in selected clinical services in Abidjan, Côte d'Ivoire. OBJECTIVE: To assess whether HCWs in Abidjan are at increased risk for occupationally acquired Mycobacterium tuberculosis infection. DESIGN: From October 1996 to January 1997, consenting HCWs from four services where tuberculosis (TB) prevalence among patients was high and two services where it was low were evaluated with a questionnaire, TST (including evaluation of anergy) and chest radiograph. RESULTS: Of the 512 participants, 405 (79%) had a TST reaction of > or =10 mm, eight (2%) were anergic, five (1%) had a radiograph compatible with TB, and two had confirmed TB. Using a cut-off of 10 mm, we found a higher prevalence of TST positivity in services with high TB prevalence than in those with low TB prevalence (92% vs 72%; odds ratio [OR] 4.3; 95% confidence interval [CI] 2.3-8.0]) and among HCWs with direct (87%; OR 2.9; 95%CI 1.6-5.1) and indirect patient contact (80%, OR 1.7; 95%CI 1.0-2.3) than among those with minimal patient contact (69%). CONCLUSION: These findings indicate that TST positivity among HCWs is related to level of exposure to TB patients, and suggest that HCWs in Abidjan are at risk for the nosocomial transmission of TB.


Subject(s)
Health Personnel/statistics & numerical data , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Mass Screening/methods , Occupational Diseases/epidemiology , Occupational Exposure/statistics & numerical data , Tuberculin Test , Tuberculosis/epidemiology , Adult , Analysis of Variance , Cote d'Ivoire/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Prevalence , Risk Factors , Surveys and Questionnaires , Tuberculosis/diagnosis , Tuberculosis/transmission , Urban Health/statistics & numerical data
12.
Chem Pharm Bull (Tokyo) ; 48(12): 1886-9, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11145137

ABSTRACT

Several diaza-analogs of phenanthrene derived from 3-amino, 5-amino, 6-amino, 8-aminoquinolines, and 5-aminoisoquinoline were prepared to evaluate their antiplasmodial activities. All compounds showed mild to good activitiy in vitro, both on a Nigerian chloroquino-sensitive strain and on the chloroquino-resistant FcB1-Columbia and FcM29 strains. The position of the intracyclic nitrogen atom is shown to be crucial for the activities (best results are obtained with a 1,10-phenanthroline skeleton). In regard to the particular properties of this structure (metalloprotease inhibition activitiy by chelating divalent metal ions), the potential chelating site of the molecule was blocked. In this case, the biological activity of the compound was greatly enhanced, showing that the mechanism of action of such a compound is probably not correlated to metalloprotease inhibition activity.


Subject(s)
Antimalarials/chemical synthesis , Phenanthrenes/pharmacology , Animals , Antimalarials/chemistry , Antimalarials/pharmacology , Chelating Agents/chemistry , Drug Evaluation, Preclinical , HeLa Cells , Humans , Inhibitory Concentration 50 , Phenanthrenes/chemical synthesis , Phenanthrenes/chemistry , Phenanthrolines/chemistry , Plasmodium falciparum/drug effects
13.
Lancet ; 353(9163): 1469-75, 1999 May 01.
Article in English | MEDLINE | ID: mdl-10232312

ABSTRACT

BACKGROUND: There is a high incidence of opportunistic infection among HIV-1-infected patients with tuberculosis in Africa and, consequently, high mortality. We assessed the safety and efficacy of trimethoprim-sulphamethoxazole 800 mg/160 mg (co-trimoxazole) prophylaxis in prevention of such infections and in decrease of morbidity and mortality. METHODS: Between October, 1995, and April, 1998, we enrolled 771 HIV-1 seropositive and HIV-1 and HIV-2 dually seroreactive patients who had sputum-smear-positive pulmonary tuberculosis (median age 32 years [range 18-64], median CD4-cell count 317 cells/microL) attending Abidjan's four largest outpatient tuberculosis treatment centres. Patients were randomly assigned one daily tablet of co-trimoxazole (n=386) or placebo (n=385) 1 month after the start of a standard 6-month tuberculosis regimen. We assessed adherence to study drug and tolerance monthly for 5 months and every 3 months thereafter, as well as rates of admission to hospital. FINDINGS: Rates of laboratory and clinical adverse events were similar in the two groups. 51 patients in the co-trimoxazole group (13.8/100 person-years) and 86 in the placebo group (25.4/100 person-years) died (decrease In risk 46% [95% CI 23-62], p<0.001). 29 patients on co-trimoxazole (8.2/100 person-years) and 47 on placebo (15.0/100 person-years) were admitted to hospital at least once after randomisation (decrease 43% [10-64]), p=0.02). There were significantly fewer admissions for septicaemia and enteritis in the co-trimoxazole group than in the placebo group. INTERPRETATION: In HIV-1-infected patients with tuberculosis, daily co-trimoxazole prophylaxis was well tolerated and significantly decreased mortality and hospital admission rates. Our findings may have important implications for improvement of clinical care for such patients in Africa.


Subject(s)
AIDS-Related Opportunistic Infections/prevention & control , Anti-Infective Agents/therapeutic use , HIV-1 , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Tuberculosis/drug therapy , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/epidemiology , Adolescent , Adult , CD4 Lymphocyte Count , Cote d'Ivoire/epidemiology , Female , Follow-Up Studies , HIV Infections/drug therapy , HIV Infections/mortality , HIV-2 , Hospitalization/statistics & numerical data , Humans , Incidence , Male , Middle Aged , Survival Analysis , Tuberculosis/epidemiology , Tuberculosis/mortality
14.
Bull Soc Pathol Exot ; 91(4): 312-4, 1998.
Article in French | MEDLINE | ID: mdl-9846224

ABSTRACT

From December 1992 to February 1993, 104 newly diagnosed pulmonary tuberculosis patients were enrolled in a prospective cohort study to assess the response to the 6 month-short-course regimen implemented in Cote d'Ivoire. This treatment encompassed the daily intake of Rifampicin and Pyrazinamide for 2 months followed by Rifampicin and Isoniazid for the remaining 4 months. All the patients were enrolled at the Treichville Tuberculosis Treatment Centre in Abidjan, and a follow-up of 6 months was observed for each patient. All in all, 41 patients were HIV-positive whereas 63 where HIV-negative. No statistical difference was noted between HIV-positive and HIV-negative patients with regard to the completion of therapy (85% versus 87%). The cure rate after an effective 6 month-therapy was similar among HIV-positive and HIV-negative patients (83% versus 84%) as well as the treatment failure rate which was 2.4% and 3% respectively. The results clearly indicate that the 6 month-short-course regimen policy implemented in Côte d'Ivoire is as effective for the treatment of HIV-associated tuberculosis as for the treatment of tuberculosis.


Subject(s)
Acquired Immunodeficiency Syndrome/complications , Antitubercular Agents/administration & dosage , Tuberculosis/drug therapy , Adolescent , Adult , Antitubercular Agents/therapeutic use , Cohort Studies , Cote d'Ivoire , Female , Humans , Isoniazid/administration & dosage , Isoniazid/therapeutic use , Male , Middle Aged , Prospective Studies , Pyrazinamide/administration & dosage , Pyrazinamide/therapeutic use , Rifampin/administration & dosage , Rifampin/therapeutic use , Tuberculosis/complications
15.
Int J Tuberc Lung Dis ; 2(11): 926-34, 1998 Nov.
Article in English | MEDLINE | ID: mdl-9848615

ABSTRACT

SETTING: Respiratory medicine wards of the University Teaching Hospital, Abidjan, Côte d'Ivoire. OBJECTIVES: To describe the spectrum of opportunistic infection among human immunodeficiency virus (HIV) infected adults hospitalised in the respiratory medicine unit in Abidjan, and the level of immunosuppression at which these diseases occur. DESIGN: Cross-sectional study. RESULTS: Overall, 75% of patients were HIV-positive: among these patients, the most frequent diagnosis was tuberculosis, in 61%, followed by bacterial pneumonia (15%), Gram-negative septicaemia (particularly non-typhoid Salmonella) (9%) and empyema (5%). Atypical pneumonias appeared to be rare. Most HIV-positive patients had CD4 counts indicative of advanced immunosuppression: 36% had CD4 counts below 100 x 10(6)/l, 19% between 100 and 199 x 10(6)/l, 29% between 200 and 499 x 10(6)/l, and 16% above 500 x 10(6)/l. Overall in-hospital mortality was 27% for HIV-positive patients and 22% for HIV-negative patients (P = 0.5). In a multivariate analysis, the strongest independent risk factors for death were cachexia (odds ratio [OR] 7.4, 95% confidence interval [CI] 2.1-26.3), male sex (OR 4.5, 95% CI 1.2-17.4) and age over 40 (OR 4.1, 95% CI 1.0-17.2). CONCLUSIONS: Tuberculosis and bacterial infections are the major causes of respiratory morbidity in immunosuppressed HIV-infected adults in this population. Efforts to improve the management of HIV-related disease need to focus on prevention and treatment of these infections.


Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , HIV Infections/complications , Adolescent , Adult , Aged , Aged, 80 and over , Analysis of Variance , CD4 Lymphocyte Count , Cote d'Ivoire/epidemiology , Cross-Sectional Studies , Empyema/epidemiology , Female , Gram-Negative Bacterial Infections/epidemiology , HIV Infections/immunology , HIV Infections/mortality , Hospitalization , Humans , Immunosuppression Therapy , Male , Middle Aged , Pneumonia, Bacterial/epidemiology , Respiratory Care Units , Sepsis/epidemiology , Tuberculosis/epidemiology
16.
Rev Pneumol Clin ; 53(2): 79-84, 1997.
Article in French | MEDLINE | ID: mdl-9205686

ABSTRACT

Based on a selection of articles published in the literature and reports from international AIDS conferences, we present the main pulmonary complications of HIV-infection observed in sub-Saharan Africa. The different clinical studies demonstrate the predominance of infectious complications, mainly tuberculosis (29 to 44%) and bacterial pneumonia (21 to 35%). The frequency of Pneumocystis carinii pneumonia remains low (5 to 19%). Other complications (mycobacterial infection, cytomegalovirus, toxoplasmosis, cryptococcus, aspergillosis, interstitial lymphoid pneumonia, Kaposi sarcoma) are less frequent. The autopsy studies report similar results and mention the predominance of tuberculosis and pneumonia due to common germs as well as the low frequency of pneumocystosis. This analysis of work conducted in sub-Saharan Africa clearly indicate that tuberculosis remains the leading cause of morbidity and mortality in HIV-infected patients.


Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , Lung Diseases/epidemiology , Africa South of the Sahara/epidemiology , Humans , Lung Diseases/etiology , Lung Diseases/microbiology , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/etiology , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/etiology
17.
Tuber Lung Dis ; 76(6): 505-9, 1995 Dec.
Article in French | MEDLINE | ID: mdl-8593370

ABSTRACT

This article reviews the main clinical aspects and progression of HIV-related tuberculosis in Abidjan. HIV prevalence in tuberculosis patients is high, estimated at 46.2% in 1992, with a clear predominance of HIV-1 over HIV-2. More than 61% of co-infected tuberculous patients meet the WHO's clinical definition of AIDS (the Bangui definition) at the time of diagnosis of tuberculosis. This rates falls to 46-51% when cough is excluded from the definition. On X-rays, the signs of pulmonary tuberculosis in co-infected tuberculous patients are atypical in the advanced stages of HIV infection, when extra-pulmonary localization, mainly mediastinal adenopathy, is frequent. Short-course chemotherapy consisting of 2 months' unsupervised daily treatment with rifampicin/isoniazid/pyrazinamide, followed by 4 months of a daily combination of rifampicin/isoniazid, applied in the Ivory Coast since 15 July 1985, has proved successful in HIV-associated tuberculosis, with treatment effectiveness rates of more than 90%.


Subject(s)
HIV Infections/complications , Tuberculosis/complications , Adult , Antitubercular Agents/therapeutic use , CD4 Lymphocyte Count , Child , Cote d'Ivoire/epidemiology , Drug Therapy, Combination , HIV Seroprevalence , HIV-1 , HIV-2 , Humans , Radiography , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/diagnostic imaging
18.
J Acquir Immune Defic Syndr Hum Retrovirol ; 10(3): 358-65, 1995 Nov 01.
Article in English | MEDLINE | ID: mdl-7552498

ABSTRACT

We present a review of epidemiologic data collected by Projet RETRO-CI between 1987 and 1993 on trends in human immunodeficiency virus type 1 (HIV-1) and HIV-2 infections and on cases of AIDS in Abidjan, Côte d'Ivoire. Overall rates of HIV infection in pregnant women had already reached 10% in 1987, and have increased only modestly since then. In contrast, in 1992-1993, rates in men with sexually transmitted diseases and in female commercial sex workers reached 27 and 86%, respectively. The increases in infection rates have been largely due to transmission of HIV-1, whereas rates of HIV-2 have remained stable or have declined. Among persons with tuberculosis and hospitalized patients, rates of 46-71% have been reached, increases in recent years again being largely attributable to HIV-1. Among the 15,245 AIDS cases reported by Projet RETRO-CI, a steady decline in the male:female sex ratio has occurred over time, from 4.8:1 in 1988 to 1.9:1 in 1993. It is likely that AIDS cases were initially concentrated among a core group of female commercial sex workers and their male clients. A substantial proportion of sex workers and their clients originate from neighboring countries, and migration is likely to have contributed to the spread of HIV infection in West Africa. Including HIV-associated pulmonary tuberculosis as an AIDS-defining illness increased AIDS cases reported by Projet RETRO-CI by 13% in 1993. Despite a need for interventional research, careful description of the evolution of HIV/AIDS in this region remains essential.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Disease Outbreaks , HIV Infections/epidemiology , HIV-1 , HIV-2 , Acquired Immunodeficiency Syndrome/transmission , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Cote d'Ivoire/epidemiology , Disease Transmission, Infectious , Female , HIV Antibodies/analysis , HIV Infections/transmission , HIV Seroprevalence , HIV-1/immunology , HIV-2/immunology , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Male , Middle Aged , Population Surveillance , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Retrospective Studies , Seroepidemiologic Studies , Sex Work , Sexually Transmitted Diseases/epidemiology , Tuberculosis, Pulmonary/transmission
19.
Bull Soc Pathol Exot ; 88(4): 199-202, 1995 Mar.
Article in French | MEDLINE | ID: mdl-8640085

ABSTRACT

We present the results of a retrospective study of 127 cases of empyema admitted to the pneumophtisiology department of the Centre hospitalier universitaire de Treichville (Abidjan), between January 1985 and December 1989. We present the pathogens identified in the pleural fluid and the course of the disease during treatment by repeat thoraco-centesis and systemic antibiotics. During the study period, pleural empyema represented 2.7% of all admissions to the pneumophtisiology department, and 20.5% of those presenting with pleural effusions. Bacteriological examination was recovered in 88 of the 127 patients, and was positive in 57 cases (64.7% of those examined). Of those with positive bacteriology, 50 (56.8%) had non-tuberculous bacterial infections, and 7 (7.9%) had tuberculous infection. Among the non-tuberculous bacterial infections, Gram-negative bacilli were most common (72%), and Pseudomonas was the species most frequently identified (48%). The mean stay in hospital was 47 days (range 10-143) and in 82 patients (64.6%), the outcome was favourable. The presentation was complicated by encystment in 36 cases (28.4%) and 9 patients (7%) died in hospital.


Subject(s)
Pleurisy/etiology , Pleurisy/therapy , Cote d'Ivoire , Female , Gram-Negative Bacteria/isolation & purification , Humans , Male , Pleural Effusion/microbiology , Pleurisy/microbiology , Pseudomonas/isolation & purification , Retrospective Studies
20.
Med Trop (Mars) ; 55(3): 252-4, 1995.
Article in French | MEDLINE | ID: mdl-8559023

ABSTRACT

Based on autopsy findings in 70 patients infected by human immunodeficiency virus (HIV) who died in the Pulmonology Department of the Treichville University Hospital Center in Abidjan, Ivory Coast. the authors assess the incidence of tuberculosis as the cause of death and analyze the clinical, bacteriologic, and histologic features of the disease. in this population. Pulmonary tuberculosis was the first cause of death in this series accounting for 31 cases (44.2%). In 12 cases (38.7%), microscopic identification failed during hospitalization and the disease had been misdiagnosed as common bacterial pneumonia. In 29 cases (93.5%) pulmonary tuberculosis was associated with abdominal involvement. In 17 cases (54.8%) involvement of more than two organs was observed. Of the 60 abdominal sites detected during the autopsy of the 31 patients with pulmonary tuberculosis, there were 19 (31.3%) in lymph nodes, 18 (30%) in the liver, 14 (23.3%) in the spleen, and 9 (14.9%) in the kidneys. Histologic features were remarkable by the absence of typical tuberculous granulomas. The findings of this study confirm the high incidence of disseminated tuberculosis in patient infected by HIV as noted in a number of previous studies.


Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Tuberculosis/microbiology , AIDS-Related Opportunistic Infections/pathology , Adolescent , Adult , Autopsy , Cause of Death , Cote d'Ivoire , Diagnostic Errors , Female , Hospitals, University , Humans , Incidence , Male , Middle Aged , Prospective Studies , Tuberculosis/pathology
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