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Titolo:
Risk factors for negative sputum acid-fast bacilli smears in pulmonary tuberculosis: results from Dakar, Senegal, a city with low HIV seroprevalence
Autore:
Samb, B; Sow, PS; Kony, S; Maynart-Badiane, M; Diouf, G; Cissokho, S; Ba, D; Sane, M; Klotz, F; Faye-Niang, MA; Mboup, S; Ndoye, I; Delaporte, E; Hane, AA; Samb, A; Coulaud, JP; Coll-Seck, AM; Larouze, B; Murray, JF;
Indirizzi:
IMEA, INSERM, U13, Paris, France IMEA Paris FranceIMEA, INSERM, U13, Paris, France CHU Fann, Dakar, Senegal CHU Fann Dakar SenegalCHU Fann, Dakar, Senegal Hop Principal, Dakar, Senegal Hop Principal Dakar SenegalHop Principal, Dakar, Senegal Hop A Le Dantec, Dakar, Senegal Hop A Le Dantec Dakar SenegalHop A Le Dantec, Dakar, Senegal Inst Hyg Sociale, Dakar, Senegal Inst Hyg Sociale Dakar SenegalInst Hyg Sociale, Dakar, Senegal ORSTOM, Retrovirus Lab, F-34032 Montpellier, France ORSTOM Montpellier France F-34032 virus Lab, F-34032 Montpellier, France Hop Bichat Claude Bernard, F-75877 Paris 18, France Hop Bichat Claude Bernard Paris France 18 nard, F-75877 Paris 18, France Univ Calif San Francisco, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
fascicolo: 4, volume: 3, anno: 1999,
pagine: 330 - 336
SICI:
1027-3719(199904)3:4<330:RFFNSA>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS INFECTION; DAR-ES-SALAAM; MYCOBACTERIUM-TUBERCULOSIS; RADIOGRAPHIC ABNORMALITIES; MANIFESTATIONS; DIAGNOSIS; IMPACT; COMPLICATIONS; MORTALITY; KINSHASA;
Keywords:
tuberculosis; acid-fast bacilli; HIV infection; West Africa;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Samb, B Hopncetl St Maurice, INSERM, U88, 14 Rue Val dOsne, F-94415 St Maurice, Fra Hop Natl St Maurice 14 Rue Val dOsne St Maurice France F-94415 ra
Citazione:
B. Samb et al., "Risk factors for negative sputum acid-fast bacilli smears in pulmonary tuberculosis: results from Dakar, Senegal, a city with low HIV seroprevalence", INT J TUBE, 3(4), 1999, pp. 330-336

Abstract

SETTING: Two teaching hospitals in Dakar, Senegal, a West African country with a low prevalence of human immunodeficiency virus (HIV) infection. OBJECTIVE: To determine whether patients with HIV-associated pulmonary tuberculosis have fewer acid-fast bacilli (AFB) in their sputum as assessed byroutine microscopy, and to correlate the findings with systematically obtained clinical, radiographic and laboratory variables. DESIGN: Prospective study from November 1995 to October 1996 of 450 consecutive patients diagnosed with pulmonary tuberculosis. RESULTS: Tuberculosis was diagnosed in 380 patients (84.4%) by positive bacteriology, in 61 (13.6%) by a favorable response to anti-tuberculosis chemotherapy, and in nine (2.0%) by the presence of a miliary radiographic pattern. Forty (8.9%) patients were HIV-seropositive. AFB-negative smears were found in 14/40 (35.0%) of the HIV-seropositive patients with pulmonary tuberculosis compared with 71/410 (17.3%) of the seronegative patients (risk ratio [RR] = 2.02, 95% confidence interval [CI] 1.26-3.24, P 0.01). A Multivariate analysis revealed that AFB smear negativity was associated with absence of cavitation (P = 0.002), lack of cough (P 0.005), the presence of HIV seropositivity (P = 0.02), a CD4+ cell count above 200/mm(3) (P = 0.02), and age over 40 years (P = 0.03). CONCLUSIONS: Compared with HIV-seronegative patients with pulmonary tuberculosis, seropositive patients in Dakar, Senegal, are more likely to have negative sputum-AFB smears. This phenomenon has now been observed in seven ofeight sub-Saharan African countries with varying HIV seroprevalence from which reports are available.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 10:28:47