National Profile and Treatment Outcomes of Patients with Extrapulmonary Tuberculosis in BéninReportar como inadecuado




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Background

In sub-Saharan Africa, there is a dearth of published literature on extrapulmonary tuberculosis EPTB.

Objective

To describe demographic, diagnostic and HIV-status characteristics of patients with EPTB in Bénin, their treatment outcomes, and among those who completed their treatment in the Centre National Hospitalier de Pneumo-Phtisiologie CNHP-P, the proportion whose bodyweight increased during treatment.

Material and Findings

This was a retrospective cohort study with comparisons made between EPTB and new smear-positive pulmonary tuberculosis NPTB patients diagnosed in the country from January to December 2011. There were 383 EPTB patients 9% of all TB cases with a mean age of 35 years, male-female ratio of 1.3 and important regional variation. There were significantly more females p = 0.001, children <15years p<0.001 and HIV-positive patients p = 0.005 with EPTB compared with NPTB. Pleural effusion, spinal and lymph node tuberculosis accounted for 66% of all EPTB. Children <15 years represented 16% of cases, with lymph node disease being most common among them p<0.001. Of 130 EPTB patients registered in CNHP-P, 7% had a confirmed bacteriological-histological diagnosis. There were 331 86% patients who successfully completed treatment. More patients with EPTB were lost-to-follow-up compared with NPTB p<0.001 with all these patients from one region. The best treatment completion rates were in children <15 years OR:3.5, 95%CI:1.0–14.8 while patients with pleural effusion and ascites had the worst outcomes. Of 72 HIV-coinfected patients, 88% were on antiretroviral therapy ART. HIV-positive status was associated with poor outcomes while those on ART fared better. In the CNHP-P, more than 80% who completed their treatment showed an increase in bodyweight and this was more evident in HIV-positive compared with HIV-negative patients p = 0.03.

Conclusion

Patients with EPTB generally do well in Bénin, although the TB Programme would benefit through more attention to accurate diagnosis and earlier start of ART in HIV-infected patients.



Autor: Serge Ade , Anthony D. Harries, Arnaud Trébucq, Gabriel Ade, Gildas Agodokpessi, Christine Adjonou, Sophie Azon, Sévérin Anago

Fuente: http://plos.srce.hr/



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