État des lieux de la tuberculose pulmonaire à bacilloscopie positive à Niamey (Niger)

Abstract

Tuberculosis is a major public health problem and the main reason for hospital admission in developing countries. No study of tuberculosis has been undertaken in the pulmonary/tuberculosis service of Lamordé National Hospital in Niamey since its foundation in April 2009. The aim of our study is to assess the current situation of sputum positive new and relapsed cases of tuberculosis and to determine their epidemiological, clinical and therapeutic profiles. It comprised a retrospective four-year study of the records of patients hospitalized for sputum positive pulmonary tuberculosis (433 patients), both new and relapsed cases, in the pulmonary/tuberculosis service of the Lamordé National Hospital. The latter is the unique reference and management centre for lung disease for the capital of Niger. Of the 975 patients admitted to the pulmonary/tuberculosis centre 433 had sputum positive tuberculosis, both new and relapsed cases, making up 44.5% of admissions. 76.2% were male giving a sex ratio of 3.2. The mean age of the patients was 42.6 years with a range of 2-85 years. More than half of the patients (54.7%) came from the Niamey region and 68.6% were referred from there. Antecedents were tuberculosis, HIV infection and smoking in 8.3%, 6.2% and 6%, respectively. Weight loss (80.4%), productive cough (63%) and fever (68%) were the main general and functional signs identified. Sputum examination revealed the diagnosis in 99.8% of cases and 62.1% had a chest X-ray before starting treatment. Cavitation was present in 67.3% and infiltration in 46.9%. Serology for HIV was positive in 17.1%. A treatment regime was instituted in 89.6% of new cases and 10.4% of relapsed cases. The rate of recovery was 74.6% and pleurisy, which was the most common complication, developed in 5.6%. Tuberculosis constitutes the main cause of hospitalization in the pulmonary/tuberculosis service of the Lamordé National Hospital in Niamey. It is therefore necessary to educate the public and reinforce the training of health care professionals in the management of tuberculosis.