ABSTRACT
SETTING: Yalgado Ouedraogo University Health Centre and National Tuberculosis Centre, Ouagadougou, Burkina Faso. OBJECTIVE: To identify causes and circumstances leading to delays in the diagnosis of sputum-positive tuberculosis (TB). DESIGN: A cross-sectional study conducted between October and December 2001. Data were collected on reasons for consulting and admission to hospital, health units visited and diagnoses. RESULTS: Before obtaining a diagnosis, 24.5% of patients had visited a public health unit, 31% had visited a private health unit, 31% had treated themselves and 6% had visited a traditional healer. In total, 16% of visits to the National Tuberculosis Centre and the Yalgado Ouedraogo University Health Centre were initiated by the patients themselves, 43% by a relative and 41% by a health worker. The average delay to diagnosis was 4 months. Only 24.5% of patients had undergone smear microscopy compared to 44.2% who had undergone chest X-ray. The majority of patients came from the outskirts of Ouagadougou. CONCLUSION: Delays in TB diagnosis seem to be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and TB information campaigns targeted at the population (transmission, symptoms and treatment) will improve TB control in Burkina Faso.
Subject(s)
Antitubercular Agents/therapeutic use , Mycobacterium tuberculosis/isolation & purification , Patient Acceptance of Health Care , Sputum/microbiology , Tuberculosis, Pulmonary/drug therapy , Adolescent , Adult , Burkina Faso/epidemiology , Cross-Sectional Studies , Diagnosis, Differential , Female , Humans , Male , Prevalence , Retrospective Studies , Time Factors , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiologyABSTRACT
Introduction: Le noma est une affection peuconnue au Burkina Faso. Cette étude décrit les aspectsépidémiologiques et diagnostiques de 59 cas de nomaà Bobo-Dioulasso (Burkina Faso).Méthodologie C'est une étude rétrospective sur10 ans incluant tous les enfants de moins de 15 ans,hospitalisés pour noma.Résultats : L' incidence du noma est de sept cas/an. La tranche de 1-5 ans a été la plus touchée. Dans46 cas (78%), le noma est survenu sur un terrain demalnutrition, associé à une mauvaise hygiène bucco-dentaire dans 45 cas (76,3%). Le tableau clinique estcelui d'un noma évolutif dans 51 cas (51/59) et d'unnoma séquellaire dans huit cas (8/59).Discussion-conclusion : Notre incidence de 7 cas/an est plus élevée que dans certaines études. D'autrestravaux trouvent comme nous que la tranche de 1-5ans a été la plus touchée. Le noma survient sur unterrain malnutri (78%) et d'hygiène orale défec-tueuse. Il devrait être mieux connu pour un traite-ment préventif adapté
Subject(s)
Burkina Faso , Child , Noma/diagnosis , Noma/epidemiologyABSTRACT
The epidemic form of Kaposi's disease, called Kaposi-AIDS, was first described in 1981 by Hymmes in two young AIDS patients. Lung lesions are observed in 10 to 45% of patients with cutaneous Kaposi and are the second leading localization of visceral involvement after the digestive tract. Diagnosis and management of these visceral forms remains difficult. We report two cases of broncho-pulmonary Kaposi-AIDS in two patients treated for cutaneous Kaposi's disease. The diagnosis was made on the basis of epidemiological, clinical, biological, radiological, endoscopic, and histological evidence. The diagnosis was achieved by elimination after ruling out all other opportunistic diseases with pulmonary tropism. The fear of miliary tuberculosis remains strong in zones with a high prevalence of tuberculosis. Despite considerable improvement with antiretroviral drugs, especially antiproteases, outcome remains unpredictable with or without specific treatment.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Lung Diseases/complications , Skin Diseases/complications , Xeroderma Pigmentosum/complications , Adult , Anti-HIV Agents/therapeutic use , Biopsy , Bronchoscopy , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Lung/pathology , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Lung Diseases/drug therapy , Lung Diseases/pathology , Male , Protease Inhibitors/therapeutic use , Radiography, Thoracic , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/pathology , Time Factors , Xeroderma Pigmentosum/diagnosis , Xeroderma Pigmentosum/diagnostic imaging , Xeroderma Pigmentosum/drug therapy , Xeroderma Pigmentosum/pathologyABSTRACT
OBJECTIVE: The purpose of this study was to determine the clinical, radiographic, and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its clinical course in the era of HIV infection. PATIENTS AND METHODS: We reviewed retrospectively 39 patients referred to the Ouédraogo Yalgado National Hospital Center and the National Anticancer Institute between February 1996 and December 1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was obtained in 30 cases (81.8%). HIV serology was positive in 26 of the 30 patients tested (86.6%). RESULTS: Nodal mediastinal tuberculosis accounted for 1.7% of the cases of tuberculosis recorded over the same period at the Anticancer Institute. Mean age of the patients was 32.8 years and the sex ratio was 1.05 in favor of men. Clinically, a past medical history was found in 18 cases (46%) including a herpes zoster in 6 (15.4%), cough in 38 (97.5%). Weight loss (95%), fever (100%) and peripheral node enlargement (20%) were found frequently, probably related to HIV infection more than tuberculosis. Radiographically, standard x-rays evidenced associated lesions in 22 cases, with 59% having predominant parenchymatous lesions. Other localizations of tuberculosis were very frequent (42.5%). DISCUSSION: Bronchial fibroscopy is most contributive to diagnosis of mediastinal nodal tuberculosis with an 81.8% yield in our series. HIV infection had a determining effect on the disease course since among the 16 patients who died, 14 were HIV-positive (52%).
