[Tuberculosis and HIV in Bangui, Central African Republic: strong prevalence and management difficulties].
The increasing incidence of tuberculosis in relation with the HIV-AIDS epidemic poses a major public health problem in sub-Saharan Africa. The purpose of this retrospective study was to analyze the prevalence of HIV-1 infection, clinical presentation, and bacteriological findings in patients treated for tuberculosis in a hospital department in Bangui, Central African Republic between January 1996 and December 1998. Among the 1142 patients who benefited for HIV serology, HIV-1 prevalence of was 82% (IC95%: 79-85%). Most patients (92%), had not undergone HIV serology before hospitalization. Mean age was 34 years. Sex ratio F/M was 1.21. Diagnosis of tuberculosis was based mainly on clinical and radiological data. Positive sputum smears were available for only 52% of the patients. The most frequent site of tuberculosis was the lungs with no significant difference between the HIV-positive and HIV-negative groups (83% versus 79% respectively). Sputum-smear examination was positive in 42% of the patients with no significant difference between the HIV-positive and HIV-negative groups (43% versus 37%). Upon admission patients usually presented advanced disease, with 11% dying within a week after hospitalization. There was a steep increase in the prevalence of HIV in tuberculosis-infected patients in Banqui, from 32% in 1988 to 62% in 1994. In spite of the existence of a National Tuberculosis Control Program, diagnostic facilities remain limited and diagnosis of tuberculosis and HIV-infection is often delayed. Outpatient care must be improved.
Laboratoire de Rétrovirologie, Institut Pasteur, Bangui. guillaume.breton@bch.ap-hop-paris.fr
G
G
Breton
Y B
YB
Service
E
E
Kassa-Kelembho
C D
CD
Mbolidi
P
P
Minssart
D000328:Adult; D002488:Central African Republic / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000628:therapy