Abstract
Introduction: Not only is tuberculosis common in sub-Saharan Africa, but also diagnostic barriers contributed to the delay of treatment in children. We described the diagnostic possibilities of tuberculosis in the context of HIV with limited resources. Materials and Methods: A retrospective study was performed with the records of children co-infected with HIV-TB benefited from TB treatment in a pediatric center in Yaounde. The time between the onset of symptoms, diagnosis and early treatment was assessed. Results: A total of 18 files comprising all the clinical information were retained. Malnutrition (94.4%), chronic cough (88.9%) and prolonged fever (44.4%) dominated the clinical picture. Between the onset of symptoms and the evocation of tuberculosis, we recorded at least two months in more than two thirds of patients. Only 11 (61.1%) had received bacteriological research from their gastric secretions or sputum of whom 3 (27.3%) showed the presence of bacilli. The diagnosis of the other 15 was made based on clinical assessment and in the absence of response to appropriate antibiotic therapy. Conclusion: The initiation of antituberculous drugs to children co-infected with HIV was late. The delays in seeking care and financial barriers to paraclinical investigations have contributed. Strengthening the knowledge of health personnel would improve time-on treatment of tuberculosis whose diagnosis was done mostly without bacteriological evidence. The subvention of complementary tests would be a considerable contribution to our context.
Highlights
Is tuberculosis common in sub-Saharan Africa, and diagnostic barriers contributed to the delay of treatment in children
The initiation of antituberculous drugs to children co-infected with HIV was late
The situation is a problem in Cameroon, where HIV prevalence among TB adults is about 30%, and children account for 8.5% of people living with HIV [1,2]
Summary
Is tuberculosis common in sub-Saharan Africa, and diagnostic barriers contributed to the delay of treatment in children. The dual TB-HIV co-infection complicates the diagnosis of TB, it provoke the delay of treatment [3,4]. In the absence of HIV, an approach based on the symptoms is enough to evoke tuberculosis [6,7]. In this context, when it is possible to do a chest x-ray, the diagnosis becomes easy [8]. WHO recommends that any child with signs of pneumonia, who do not improve with antibiotics, should be investigated for tuberculosis [9]. WHO does not recommend any treatment for TB test diagnosis [9]
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