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Tuberculosis Re-Treatment Cases and Factors Associated with Unfavourable Outcome at the Fann University Hospital of Dakar, Senegal between 2011 and 2016: A Follow-Up Study

Introduction: The aim of our study was to describe the socio-demographic, clinical, therapeutic and evolutionary characteristics of patients admitted to tuberculosis re-treat- ment and managed at the The Infectious and Tropical Dis- eases Department (SMIT) screening and tuberculosis treat- ment center (TTC), to determine the factors associated with unfavourable outcome Methodology: This is a descriptive and analytical retro- spective cross sectional study covering all tuberculosis re-treatment cases monitored in the service of infectious and tropical diseases in Fann from 1 January 2011 to 31 December 2016. The Epi-Info software version 7 CDC and SAS (version 9.3, Cary, NC, USA) were used for data entry and analysis. Results: We collected 83 patients as re-treatment tubercu- losis cases during the study period, for an annual average of 14 cases. The average age of the patients was 42.2 years ± 13.6 years, with extremes of 16 and 77 years. There was a male predominance (66.3%) with a sex ratio of 1.96. The majority (95.2%) of our patients came from the Dakar re- gion, 42.2% of them from the suburban area. More than two thirds (77.1%) of our patients were hospitalized. Clinically, the average weight at initiation of tuberculosis treatment was 48.1 kg ± 9.9 kg. The isolated pulmonary form account- ed for 63%, followed by the multifocal form 23%. HIV sero- prevalence was 73.6% and 92.9% of these patients were on cotrimoxazole chemoprophylaxis and 60.7% on ARV treat- ment. Relapses (61.4%) and treatment after default (36.1%) constituted the majority of the re-treatment circumstances. The unfavourable outcome was related to provenance in suburban areas and outside Dakar (AOR = 17.5; 95% CI: 3.61 - 85.4). Conclusion: Compliance and monitoring of retreatment cases is important to avoid TB drug resistance. It is neces- sary to improve the referral and counter-referral system as well as communication between the different tuberculosis treatment centers.


Auteur(s) : VIVIANE MARIE PIERRE CISSÉ DIALLO, LOUISE FORTES DÉGUÉNONVO, AMINATA MASSALY, NDÈYE AÏSSATOU LAKHE, DAYE KA, KHARDIATA DIALLO M BAYE, NDÈYE FATOU NGOM
Année de publication : 2019
Revue : J Infect Dis Epidemiol.2
Type : Article
Mise en ligne par : FORTES Louise