Outcome of patients with tuberculosis and AIDS in Abidjan (Ivory Coast)

Objective - The authors studied the outcome of patients with tuberculosis and AIDS in order to improve the quality of care. Methods - A prospective and longitudinal study was made from December 1996 to January 1998, in pneumophtisiology and infectious diseases. Results - Two hundred and seventeen patients were enrolled (150 in the PPH and 67 in the infectious diseases department). The mean age was 35 years, (16-64 years), the sex ratio 1: 9. Two hundred and thirteen patients (98%) had a low or median socioeconomic level, 71 (33%) were foreigners, 49 (29%) lived in a district with an antituberculosis center, and 114 (52.5%) had a home address. We found lung tuberculosis in 108 cases (49%), and extrapulmonary or disseminated tuberculosis in 109 patients (51%). Tuberculosis was confirmed in 62 cases (30%). One hundred and seventy-one patients (80%) were referred to the antituberculosis centers, 25 (11%) died, and 21 (10%) were lost during their hospital stays. Recovery rate after six months of treatment was 54%, the rate of those lost during follow up 31%, and lethality was 15%. On follow-up at four months, 30% of the 115 patients had recovered and seven (6%) had died. Discussion - For short-course therapy in patients with AIDS, there is an important rate of non-compliance, and also an important rate of those lost during follow-up above the 10% threshold recommended by the WHO. The factors which influenced this high rate of noncompliance were the low socioeconomic level, the lack of a home address, extrapulmonary tuberculosis, and the association with opportunistic infections.