Horo K, Aka-Danguy E, Kouassi Boko A, N'gom A S, Gode C V, Ahui Brou J M, Motuom A F, Yacouba T, Koante-Kone F, Tcharman M T, Koffi N
Service de pneumologie, CHU, Cocody, Abidjan, Côte d'Ivoire.
Rev Pneumol Clin. 2011 Apr;67(2):82-8. doi: 10.1016/j.pneumo.2010.06.002. Epub 2010 Dec 3.
The Ivory Coast management of chronic tuberculosis (TB) began in 2000.
The aim of this study is to determine the characteristics of the patients monitored for chronic TB and note the difficulties in patient management and outcome.
A retrospective review of the medical records of the patients receiving second-line treatment for chronic tuberculosis for at least 12 months.
Eighty-one medical records were included. The average of age was 33.37 years. The sex ratio was 2.68. All of the patients lived in conditions of promiscuity. The recommendations for the treatment of failures and relapses were not always respected: 33.33% did not comply with the protocols, 53.1% non-prescription of the mycobiogramme and 22.2% non-respect for the follow-up calendar. During the diagnosis of the chronic tuberculosis, bilateral radiological lesions were found in 72.5% of the cases and one lung was destroyed in 14.7% of the cases. The isolates were Mycobacterium tuberculosis. The multi-drug-resistance of Mycobacterium tuberculosis was estimated at 95.5%. The side effects of the treatments were polymorphous with a frequency ranging from 46.4% to 61.3% during the follow-up period. The outcome of the patients is the following: 39.2% dropped out; 15.2% died; 30.4% were in the attack phase; 5.1% were cured; 5.1% were in the consolidation phase.
The results of the treatment are disappointing. It is urgent to develop a strategy to reduce the number of drop-outs and provide the early diagnosis and treatment of multi-drug resistant tuberculosis.
科特迪瓦慢性结核病管理始于2000年。
本研究旨在确定接受慢性结核病监测患者的特征，并记录患者管理中的困难及治疗结果。
对接受二线治疗至少12个月的慢性结核病患者的病历进行回顾性分析。
纳入81份病历。平均年龄为33.37岁。性别比为2.68。所有患者生活在拥挤环境中。治疗失败和复发的建议并非总是得到遵守：33.33%未遵守方案，53.1%未进行真菌培养检查，22.2%未遵守随访日程。在慢性结核病诊断期间，72.5%的病例发现双侧放射性病变，14.7%的病例有一侧肺毁损。分离出的是结核分枝杆菌。结核分枝杆菌的多药耐药率估计为95.5%。治疗的副作用多种多样，随访期间发生率在46.4%至61.3%之间。患者的治疗结果如下：39.2%退出治疗；15.2%死亡；30.4%处于发作期；5.1%治愈；5.1%处于巩固期。
治疗结果令人失望。迫切需要制定一项战略，以减少退出治疗的人数，并提供多药耐药结核病的早期诊断和治疗。
