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The purpose of this study was to estimate the impact of HIV infection on hematological abnormalities detected during pulmonary tuberculosis in African adults. The charts of all patients over 14 years in whom diagnosis of pulmonary tuberculosis was confirmed by bacilloscopy and a hemogram was performed were reviewed. Thoracic radiography demonstrated unilateral and bilateral lesions. Two parallel mixed ELISA HIV tests were performed. A total of 98 patients with a mean age of 39 years were included in study. The male/female sex ratio was 0.88. HIV seroprevalence was 65%. Hemograms showed anemia in 95% of cases, leucopenia in 20%, neutropenia in 35%, lymphopenia in 42%, and thrombopenia in 3%. No correlation was found with type of lung disease. Anemia (p = 0.001), leucopenia (p = 0.01) and thrombopenia (p = 0.001) were more extensive in HIV-infected patients. Hematological abnormalities were multiform. Cytopenia was the most frequent disorder and was positively correlated with HIV infection.

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The purpose of this retrospective study was to determine the epidemiological features of tuberculosis patients under the age of 15 years treated at the Tuberculosis Control Center in Libreville, Gabon from 1997 to 2001 as a basis for improving management. Study criteria included age, sex, BCG vaccination status, social level, type of tuberculosis, HIV status and outcome of treatment. Statistical analysis was performed using EPI INFO software. The childhood tuberculosis rate was 9% with a sex ratio of 1.02 and the most common age group was 0 to 4 years. Three fourths of children were from poor zones and 90% had received BCG vaccination. The incidence of tuberculosis did not increase from year to year. The location of tuberculosis was pulmonary in 77% of cases (n=433) and extrapulmonary in 23% (n=129). No case involving meningitis or miliary disease was observed. Sputum bacilloscopy was positive in 21% of cases involving pulmonary tuberculosis and HIV serology was positive in 4.4% of children tested. The success rate was 54%. Tuberculosis-related mortality was 0.7% but 37% of children were lost from follow-up. Efforts to control tuberculoses by screening children exposed to bacilliferous conditions and vaccinating newborns must be continued. Treatment for tuberculosis must be given free of charge and under medical supervision as recommended by the World Health Organization.

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Nous avons realise une etude retrospective pour determiner les caracteristiques epidemiologiques des patients tuberculeux de moins de 15 ans suivis au Centre antituberculeux de Libreville de 1997 a 2001 afin d'en ameliorer la prise en charge. Les donnees reprenaient l'age; le sexe; la notion de BCG; le statut social; le type de maladie tuberculeuse; le statut VIH et l'issue du traitement. L'analyse statistique a ete faite grace au logiciel Epi Info. La tuberculose concernait 9d'enfants avec un sex ratio de 1.02 ; la tranche d'age de 0 a 4 ans etait la plus atteinte. Trois quarts des enfants provenaient des zones defavorisees et 90etaient vaccines par le BCG. L'incidence de la tuberculose n'augmente pas d'une annee a l'autre. Nous avons determine 77(n= 433) de tuberculose pulmonaire et 23(n= 129) d'extra pulmonaire. Aucune meningite ni miliaire n'a ete retrouvee. La bacilloscopie etait positive dans 21des cas de tuberculose pulmonaire et la serologie VIH positive chez 4;4des enfants testes. Le taux de succes est de 54; la mortalite imputable a la tuberculose de 0;7; et 37des enfants suivis sont perdus de vue. Le depistage des enfants doit etre poursuivi autour des cas bacilliferes; de meme que la vaccination chez le nouveau-ne. Le traitement antitu- berculeux doit etre gratuit et supervise comme recommande par l'Organisation Mondiale de la Sante

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There are nearly 31,000 HIV infected patients in Gabon. In Libreville, the capital, the prevalence is estimated at 7.7%. About 2627 tuberculosis patients, all types included, have been notified in 2001 to the World Health Organization of which 43% of smear positive new cases. The co-infection HIV-TB worsens the overall prognosis of our patients. The objective of our study is to determine the HIV seroprevalence among our tuberculosis patients. It is a cross-sectional study conducted between June 25th and August 31th 2001. All patients are new or relapse tuberculosis cases. There is no difference between the types of tuberculosis. The diagnosis was clinical, radiological and based on smear AFB sputum (according to the Ziehl Neelsen method). The patients agreed orally for HIV testing. We made two tests: a rapid one followed by Elisa if positive. 358 patients were examined among them 141 women and 217 men. The M/F sex ratio was 1.53 and the average age 32 years. Proportion of new patients reached 61%. Ninety seven per cent of patients suffered from a pulmonary tuberculosis, 58% smear positive and 26% were HIV-1 positive. According to this status, no statistical difference was notified towards sex, types of disease or patients and the smear sputum results.

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We are reporting here the data of two surveys carried out in Libreville between 1982 and 1985. The first one was done with 153 women at the maternity hospital of le centre hospitalier de Libreville, the other one involved 623 women at antenatal visit. In this last group, the rate of women being seropositive is in inverse ratio to the social status, with women from high income strata having a percentage of 1,5 to 3,4% and women from lower income strata starting at 21% up to 26% of seropositivity. Promiscuity and lack of information among youngster could explain the relatively high percentage of seropositivity among female pupils and students (10.6%). We suggest to consider this group as a risk group for syphilis and to focus all necessary information toward this group and the lower income women strata of the population. Getting back to 153 women at the maternity hospital, 31 of them (20.3%) were seropositive and the ground of their admission to the hospital was: 27 delivery of death in utero, 1 case of abortion at 3 months of pregnancy, 2 cases of miscarriage at the 5 month and one case of hypotrophic fetal development, because the mother was treated for syphilis during pregnancy. The risk of congenital syphilis is low when the mother has been treated during pregnancy, so, the high number of congenital syphilis, 12/47 pregnancies followed up to delivery are an indication of an inadequacy or a total lack of treatment during those pregnancies.

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