感染症と医学ジャーナル

Tuberculosis Treatment Outcomes at a University Hospital in Senegal: A Retrospective Study of 1030 Cases

Abstract

Louise Fortes Déguénonvo, Viviane Marie Pierre Cisse Diallo, Ndèye Aissatou Lakhe, Khardiata Diallo Mbaye, Daye Ka, Assane Diouf, Aminata Massaly, Alassane Dièye, Ndeye Fatou Ngom Guèye, Cheikh Tacko Diop, Noelle A Benzekri, Cheikh Tidiane Ndour and Moussa Seydi

Introduction: Determining treatment outcomes is a key component of the fight against tuberculosis. This has become even more important with the emergence of multidrug resistant TB. The objective of this study was to determine the outcomes of patients treated for tuberculosis within the National Program for the Fight AgainstTuberculosis (NTP) in Senegal.

Methods: We conducted a retrospective cohort study involving all patients treated for tuberculosis in the Department of Infectious Diseases at the Fann University Hospital in Senegal from January 1, 2011 to December 31, 2014. Data were entered and analysed using the software Epi-Info 3.7.1. The Chi-square test was used to compare treatment outcomes in 2011 versus 2014.

Results: Data were collected for 1030 cases of tuberculosis. Pulmonary (49%), lymphatic (15.9%) and neuromeningeal tuberculosis (11.7%) were the main sites of involvement. The mean weight gain was 5.3 ± 4 kg. TB  treatment outcomes were distributed as follows: 504 (49%) treatment success, 278 (27%) deaths, 103 (10%) lost to follow-up, 143 (13.9%) transferred out and 1 (0.1%) failed. The therapeutic success rate fluctuated from 45.4% to 59.5% between 2011 and 2014 (p=0.07). The proportion of patients lost to follow-up decreased significantly from 15.3% to 3.5% (p<0.001). However, mortality increased from 22% to 31% (p=0.001).

Conclusion: Tuberculosis treatment success rate within this hospital population remains low. Early detection of tuberculosis and HIV is the key point to improve outcome treatment.