Prise en charge de la tuberculose chez l’enfant en 2010 au centre de Paul-Faure de Djibouti

Kamate, Mahesh; Osman, Muhammad; Mohamed, Younes; Hoche, S.

doi:10.1016/j.rmr.2011.10.925

Cited by 1 publication

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“…The overall treatment success rate, at 72%, was higher than that reported in Malawi (45%), 21 but lower than in Djibouti in 2010 (84%). 26 A higher treatment success rate of 86% in smear-positive cases was close to that reported for adults (90%); 2 overall better treatment outcomes could be obtained through better monitoring systems to reduce loss to follow-up and unknown outcomes, and possibly by more accurate diagnosis. For example, unknown outcomes were particularly common in children registered and treated at the GH.…”

Section: Discussionsupporting

confidence: 52%

The burden and outcomes of childhood tuberculosis in Cotonou, Benin

Adè

Harries

Trébucq

et al. 2013

public health action

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(grouped together into the 0-14 year age group) are specifi cally identifi ed in the NTP's quarterly reports. At the General Hospital (GH) in Cotonou, the economic capital, children are diagnosed and treated on the basis of information recorded in their personal medical fi les, but are never notifi ed to the NTP, for a variety of reasons. NTP data on children are therefore incomplete and cannot be used to estimate the true burden of childhood disease in Benin.The aim of the present study was to describe the burden of TB and characteristics and outcomes along children treated in Cotonou, Benin. Specifi c objectives were to determine: 1) the total number of TB cases recorded in the NTP TB registers, and of these, the number of children aged <15 years; 2) the incidence rate of notifi ed TB cases among children aged <15 years; 3) the number of children notifi ed with TB in the NTP TB register and the number of children recorded in the GH medical fi les (who are not notifi ed in the NTP TB register) and, in each of these groups, stratifi cation by sex, age, type of TB and human immunodefi ciency virus (HIV) status; and 4) the treatment outcomes among these children stratifi ed by place of treatment, sex, age, type of TB and HIV status, from 2009 to 2011. STUDY POPULATION, DESIGN AND METHODS Study designThis was a cross-sectional, retrospective cohort study of children with TB in Cotonou based on reviews of NTP TB registers and the medical fi les of the GH. SettingBenin is a small country in West Africa with a population of 9 million and a gross national income of US$780 per capita (http://data.worldbank.org/about/countryclassifi cations). The NTP notifi es about 3500 TB cases each year. The national incidence rate of notifi ed new TB cases has been stable over the last 10 years, at 41-46 per 100 000 population. The NTP follows the DOTS strategy and uses internationally recognised criteria for diagnosing and treating patients with TB. 6,7 The NTP has a central unit responsible for policy and strategy, while diagnosis, registration and care are decentralised to 57 public or private basic management units (BMUs) in the country.The present study was conducted in Cotonou and its suburbs, which has a population of about 1 million. There are fi ve BMUs in Cotonou, all of which have a TB register and use TB treatment cards. The GH has a Interna onal Union Against Tuberculosis and Lung DiseaseHealth solu ons for the poor by the NTP and 29 (16%) by the GH; the latter were not notified to the NTP. The incidence rate of notified TB cases was between 8 and 13 per 100 000 population, and was higher in children aged >5 years. Of 167 children tested, 29% were HIV-positive. Treatment success was 72% overall, with success rates of 86%, 62% and 74%, respectively, among sputum smear-positive, sputum smear-negative and extra-pulmonary patients. Treatment success rates were lower in children with sputum smear-negative TB (62%) and those with HIV infection (58%). Conclusion:The number of children being treated for TB is low, and younger ch...

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Section: Discussionsupporting

confidence: 52%