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GOALS: We studied the socio-demographic and paraclinicalcharacteristics of tuberculosis patients to identify the factors associated with their deaths in Bamako. MATERIALS AND METHODS: A retrospective cohort study was carried out on tuberculosis patients registered in Bamako from October 1, 2017 to September 30, 2018. Quantitative variables were presented by their mean, qualitative ones by their proportions. Analysis was performed with R version 3.5.0. RESULTS: Out of 2396 patients enrolled, 25 to 45-year olds represented 50.3% and children 4.51%; the average age 37.3 years; the sex ratio M/F 1.94 and co-infected TB/HIV 8.64%. 25 to 45 year olds (HR=2.58; 95% CI [1.35-4.92]; p=0,0042) and those ≥ 46 years (HR=4.64; 95% CI [2.39-9.01] ; p=5.69e-06) and positive HIV status (HR= 5.87 ; 95% CI [2.24-15.41] ; p= 0.0003) were associated with an increased risk of patient death. CONCLUSION: Tuberculosis affects young and old males. The risks of death identified were the patient's age and positive HIV status. We recommend specific monitoring of patients aged 25 to 45 and 46 and over and those with positive HIV status.
BUTS: Nous avons étudié les caractéristiques sociodémographiques et paracliniques des tuberculeux pour identifier les facteurs associés à leurs décès à Bamako. MATÉRIELS ET MÉTHODES: Une étude de cohorte rétrospective a été menée portant sur les tuberculeuxenregistrés à Bamako du 1er octobre 2017 au 30 septembre 2018. Les variables quantitatives étaient présentées par leur moyenne et celles qualitatives par leurs proportions. L'analyse a été effectuée avec R version 3.5.0. RÉSULTATS: Sur 2396 patients enrôlés, les25 à 45 ansreprésentaient 50,3 % et les enfants 4,51% ; l'âge moyen 37,3 ans ;le sex-ratio H/F 1,94 etles coinfectés TB/VIH 8,64%. Les25 à 45 ans (HR=2,58 ; IC95% [1,35-4,92] ; p=0,0042) et ceux ≥46 ans (HR=4,64 ; IC95% [2,39-9,01] ; p=5,69e-06) et le statut VIH positif (HR= 5,87 ; IC95% [2,24-15,41] ; p= 0,0003) étaient associés à une augmentation du risque de décès des patients. CONCLUSION: La tuberculose affecte les jeunes et les personnes âgées de sexe masculin. Les risque de décès identifiés étaient l'âge et le statut VIH positifdu patient.Nous recommandons une surveillance spécifique des patients de 25 à 45 ans et 46 ans et plus et ceux avec statut VIH positif.
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INTRODUCTION: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the microbes implicated in meningitis epidemics in Niger. METHODS: We conducted a descriptive study (a secondary analysis) of meningitis data from 2008 through 2015. The study population comprised patients with suspected and confirmed meningitis. We conducted an exhaustive sampling of all suspected and confirmed meningitis cases reported in Niger from 2008 to 2015. RESULTS: A total of 6167 (40.6 %) confirmed cases of meningitis were identified. Among them, 5,507 (89.3 %) were attributable to Neisseria meningitidis, 593 (9.6 %) to Streptococcus pneumoniae, and 66 (1.1 %) to Haemophilus influenzae respectively. Among the Neisseria meningitidis cases, 2,984 (54.2 %) were caused by serogroup A, 1,333 (24.2 %) by serogroup W, 1,165 (21.1 %) by serogroup C, 23 (0.4 %) by serogroup X, and 2 (0.03 %) by the serogroup B. CONCLUSION: This study enabled us to describe meningitis trends and identify the profile of the bacteria implicated in its epidemics in Niger. We observed the emergence of Neisseria meningitidis C and recommend vaccination against this serogroup.
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Meningitis por Haemophilus/epidemiología , Meningitis Meningocócica/epidemiología , Meningitis Neumocócica/epidemiología , Análisis de Datos , Humanos , Niger/epidemiología , Factores de TiempoRESUMEN
AIM: To analyze the factors associated with the time to initiating tuberculosis contact investigations in the Somme department, France. METHODS: All reported tuberculosis cases and all their contacts screened between 2007 and 2011 were retrospectively included. Univariate and multivariate analyses were conducted to determine the factors associated with a "system delay"≤1 month and a "contact delay"≤0 days. RESULTS: The mean time between the mandatory notification of a case of tuberculosis and the date set for the contact's screening (system delay) was 35.3 days and the average time between that date and when the contact was actually screened (contact delay) was 12.5 days. In multivariate analysis, a smear-positive sputum sample (OR: 3.68; 95% CI: 1.63-8.30) and a diagnosis at the university hospital (OR: 2.61; 95% CI: 1.14-5.96) were significantly associated with a system delay≤1 month. A smear-positive sputum sample (OR: 1.35; 95% CI: 1.08-1.69), male gender (OR: 1.21; 95% CI: 1.01-1.49), being born in a foreign country (OR: 1.31; 95% CI: 1.02-1.69), being a family member (OR: 1.37; 95% CI: 1.05-1.77), or being another type of close contact of the case (OR: 2.47; 95% CI: 1.81-3.36) were significantly associated with a contact delay≤0 days. CONCLUSION: System and contact delays were longer than recommended, and the factors associated with the lengthening of these delays need to be taken into account.
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Trazado de Contacto/estadística & datos numéricos , Diagnóstico Tardío/estadística & datos numéricos , Tuberculosis/diagnóstico , Tuberculosis/transmisión , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Femenino , Francia/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: The associated factors contributing to a delay in mandatory tuberculosis notification in the Somme department, France, are not yet known. The objective of this study was to analyze these factors. METHODS: All reported cases of tuberculosis between 2007 and 2011 were retrospectively included. Univariate and multivariate analyses were conducted to investigate the factors associated with a short time to notification, i.e., ≤48h. RESULTS: Between 2007 and 2011, a total of 175 cases of tuberculosis were reported to the Somme Regional Health Agency. Of the 145 (83.8%) cases of tuberculosis with at least one pulmonary location, 57.7% had a positive sputum smear. The mean time between the diagnosis of tuberculosis and mandatory notification was 6.1 days. It was 2.6 days for tuberculosis cases with a positive sputum smear versus 8.3 days for cases with a negative sputum smear; 2.0 days for severe cases and 6.3 days for simpler forms. In multivariate analysis, only a positive sputum smear was significantly associated with a short time to mandatory notification (OR 2.44; 95%CI 1.18-5.00; P=0.02). CONCLUSION: The time to mandatory notification is longer than recommended. Better collaboration between the parties involved in tuberculosis control and their continuing medical education could reduce this delay in the Somme department.