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Afriyie-Mensah JS, Aryee R, Zigah F, Amaning-Kwarteng E, Séraphin MN. The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility. Tuberc Res Treat 2023; 2023:6648137. [PMID: 38161389 PMCID: PMC10757658 DOI: 10.1155/2023/6648137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/27/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024] Open
Abstract
Aim We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. Methods We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. Results A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. Conclusion The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.
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Affiliation(s)
- Jane S. Afriyie-Mensah
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Robert Aryee
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- Department of Cardiology, University of Ghana Medical Centre, Accra, Ghana
| | | | - Ernest Amaning-Kwarteng
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Marie Nancy Séraphin
- Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL 2610, USA
- Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, College of Medicine, Gainesville, FL 32610, USA
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Chukwuocha IK, Johnson SM, Aguoru EP. Prevalence, Profile and Treatment Outcome of Tuberculosis-Human Immunodeficiency Virus Co-Infection in South Eastern Nigeria: A 3-Year Retrospective Study. Niger Med J 2023; 64:789-798. [PMID: 38979051 PMCID: PMC11227634 DOI: 10.60787/nmj-64-6-372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
Background Tuberculosis (TB) and the Human Immune Deficiency Virus (HIV) represent major public health challenges and are intricately linked to each other. This is more prevalent in the sub-Saharan African region, where about 80% of this co-infection is recorded. This study aimed to review the prevalence, profile, and treatment outcome of TB-HIV co-infected patients. Methodology A hospital-based retrospective study was conducted in a tertiary center in southeast Nigeria for the period 2015-2017. Information elicited from participant's medical records included socio-demographic profile (age, sex, residential area, and occupation), Cluster of Differentiation 4 (CD4) count level at the time of diagnosis of co-infection, weight, treatment outcome, as well as the record of the number of TB patients who presented within this same period. Results The total number of TB/HIV co-infected patients who participated in the study during this period was 207, with a prevalence of TB/HIV co-infection of 33.9%. The highest proportion of cases was recorded among participants within the age group of 31-40, and the cases of co-infection were more common in males (58.9%) and students (27.5%). The results also showed a significant relationship between gender, occupation, residential area, and TB/HIV co-infection. Most of the co-infected participants had a CD4 count of <300 cells/mm3 and an associated poor treatment outcome of 41.1%. Conclusions TB/HIV co-infection needs to be properly addressed, and screening for HIV among TB patients should be a priority. This will help in early diagnosis and subsequently improve the treatment outcome of both diseases.
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Affiliation(s)
| | - Simon Mafuka Johnson
- Department of Internal Medicine, Federal University Teaching Hospital Owerri, Owerri, Nigeria
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Guessogo WR, Mandengue SH, Assomo Ndemba PB, Medjo UO, Minye EE, Ahmaidi S, Temfemo A. Physical and functional follow-up of tuberculosis patients in initial intensive phase of treatment in Cameroon using the 6-min walk test. J Exerc Rehabil 2016; 12:333-9. [PMID: 27656631 PMCID: PMC5031382 DOI: 10.12965/jer.1632620.310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/14/2016] [Indexed: 12/20/2022] Open
Abstract
This study aimed to evaluate functional capacities of Cameroonian tuberculosis (TB) patients in initial intensive phase of treatment using the 6-min walk test (6MWT) and to compare them to an age-matched healthy group. Twenty-eight TB patients newly diagnosed and 19 healthy age-matched peoples participated in the study. Performance parameters were determined using the 6MWT. Anthropometric and cardiorespiratory parameters were measured at baseline and after 6MWT. Two months later, TB patients were submitted to the same evaluation. We found significant differences in anthropometric parameters between the two groups. The baseline cardiorespiratory parameters and performance characteristics of TB patients were lower than control group (571.7±121.0 m vs 841.6±53.0 m, P<0.0001 for 6-min walk distance (6MWD) and 18.1±2.8 mL/kg/min vs 24.3±1.2 mL/kg/min, P<0.001 for mean VO2 peak (peak oxygen consumption). Two months after, significant improvements were noted in anthropometric, cardiorespiratory and performance parameters except for bone mass and FEV1/FEV6 (forced expiratory volumes in 1 second/6 seconds) ratio. Significant correlations were found between the 2-min walked distance (P<0.0001, r=0.95), 4-min walked distance (P<0.0001, r=0.97) and 6MWD. In conclusion, TB patients have impaired physical functional capacity but they improved after 2 months of treatment. 6MWT can be a useful tool in the assessment of physical parameters and cardiorespiratory functional capacity rehabilitation of TB patients during the treatment.
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Affiliation(s)
- Wiliam R Guessogo
- National Institute of Youth and Sports of Yaounde, Yaounde, Cameroon; Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon
| | - Samuel H Mandengue
- Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon; Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Peguy B Assomo Ndemba
- Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon
| | | | - Edmond Ebal Minye
- National Institute of Youth and Sports of Yaounde, Yaounde, Cameroon
| | - Said Ahmaidi
- Laboratoire EA3300 - APERE: Adaptations Physiologiques à l'Exercice et Réadaptation à l'Effort, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, Cedex, France
| | - Abdou Temfemo
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; Laboratoire EA3300 - APERE: Adaptations Physiologiques à l'Exercice et Réadaptation à l'Effort, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, Cedex, France
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Bélard S, Remppis J, Bootsma S, Janssen S, Kombila DU, Beyeme JO, Rossatanga EG, Kokou C, Osbak KK, Obiang Mba RM, Kaba HM, Traoré AN, Ehrhardt J, Bache EB, Flamen A, Rüsch-Gerdes S, Frank M, Adegnika AA, Lell B, Niemann S, Kremsner PG, Loembé MM, Alabi AS, Grobusch MP. Tuberculosis Treatment Outcome and Drug Resistance in Lambaréné, Gabon: A Prospective Cohort Study. Am J Trop Med Hyg 2016; 95:472-80. [PMID: 27352879 DOI: 10.4269/ajtmh.15-0668] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 04/11/2016] [Indexed: 12/16/2022] Open
Abstract
Despite overall global progress in tuberculosis (TB) control, TB remains one of the deadliest communicable diseases. This study prospectively assessed TB epidemiology in Lambaréné, Gabon, a Central African country ranking 10th in terms of TB incidence rate in the 2014 World Health Organization TB report. In Lambaréné, between 2012 and 2014, 201 adult and pediatric TB patients were enrolled and followed up; 66% had bacteriologically confirmed TB and 95% had pulmonary TB. The human immunodeficiency virus (HIV) coinfection rate was 42% in adults and 16% in children. Mycobacterium tuberculosis and Mycobacterium africanum were identified in 82% and 16% of 108 culture-confirmed TB cases, respectively. Isoniazid (INH) and streptomycin yielded the highest resistance rates (13% and 12%, respectively). The multidrug resistant TB (MDR-TB) rate was 4/91 (4%) and 4/13 (31%) in new and retreatment TB cases, respectively. Treatment success was achieved in 53% of patients. In TB/HIV coinfected patients, mortality rate was 25%. In this setting, TB epidemiology is characterized by a high rate of TB/HIV coinfection and low treatment success rates. MDR-TB is a major public health concern; the need to step-up in-country diagnostic capacity for culture and drug susceptibility testing as well as access to second-line TB drugs urgently requires action.
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Affiliation(s)
- Sabine Bélard
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jonathan Remppis
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany
| | - Sanne Bootsma
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Saskia Janssen
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Davy U Kombila
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon
| | | | | | - Cosme Kokou
- Hôpital Albert Schweitzer de Lambaréné, Lambaréné, Gabon
| | - Kara K Osbak
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Régis M Obiang Mba
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Harry M Kaba
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Afsatou N Traoré
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Microbiology Department, University of Venda, Thohoyandou, South Africa
| | - Jonas Ehrhardt
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany
| | - Emmanuel B Bache
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Arnaud Flamen
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Sabine Rüsch-Gerdes
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, Borstel, Germany
| | - Matthias Frank
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany
| | - Ayôla A Adegnika
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany
| | - Stefan Niemann
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, Borstel, Germany
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany
| | - Marguerite M Loembé
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany. Bacteriology and Virology Department, Université des Sciences de la Santé, Libreville, Gabon
| | - Abraham S Alabi
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné, Hôpital Albert Schweitzer, Lambaréné, Gabon. Institut für Tropenmedizin, Universitätsklinikum Tübingen, Eberhard Karls Universität, Tübingen, Germany. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
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