Objective: To determine the predictive factors for the occurrence of tuberculosis (TB) in adults infected with the human immunodeficiency virus (HIV) during the first 6 months of antiretroviral therapy (ART) in Kisangani. Methods: A case-control study was carried out during the period from January 1, 2017 to December 31, 2018. Clinical data were collected retrospectively from patients receiving antiretroviral therapy in the city of Kisangani. Of a total of 1,161 HIV-infected patients included in this study, 58 of them developed TB. The diagnosis of tuberculosis was made on the presence of Acid-Alcohol-Resistant Bacile (BAAR) on at least one biological sample or on the basis of a bundle of clinical and paraclinical arguments. This test is done during the first six months of initiating anti retroviral therapy (ART). Predictive factors for the onset of TB in these patients on antiretroviral therapy were identified using logistic regression analysis. Results: After multivariate analysis, the independent factors associated with the onset of TB were: being married (OR = 4.456; 95% CI: 1.061-18.713), residence in the town of Tshopo (OR = 7.04; 95% CI: 1.168-42.47) as well as stages 3 and 4 of AIDS disease (OR = 29 95% CI: 4.563-184.872 and OR = 50.8 95% CI: 3.971-680.995). Conclusion: The results found by this study highlight the need for active TB testing in HIV-infected individuals. Particular emphasis should be placed on the category of patients on antiretroviral therapy who have one of the independent factors for the onset of TB.
It has been known since March 2013 that Artesunate is considered the gold standard treatment for severe malaria [1] [2] [3]. However, in our regions, the drug of choice available to treat patients with severe malaria remains quinine until today. However, frequent and sequential use of quinine is associated with the occurrence of hemoglobinuria [2]. We report a probable case of bilious hemoglobin fever (BHF) in an 8-year-old child. This was an 8-year-old child with a history of frequent and recent treatment with quinine, received in consultation for coca-cola urine emission with rapid diagnostic test (RDT) positive. In search of a particular terrain, the retroviral and syphilitic serologies were negative. Considering the context, the diagnosis of post-quinine hemoglobin bilious fever (BHF) was retained and the patient had progressed well after administration of artemisinin and its derivatives. The child was followed, on an outpatient basis, without any sequelae. It would therefore be prudent for the time being to avoid them in prophylaxis and self-medication.
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