Aspects diagnostiques et cliniques de la tuberculose infantile : à propos de 94 cas colligés en milieu hospitalier à Abidjan, Côte d’Ivoire, de 2015 à 2017 Raoul

La tuberculose infantile (TBI) reste largement sous notifiée. La principale raison de la sous-notification est la difficulté diagnostique. Le diagnostic précoce et la prise en charge de la TBI demeurent donc un défi constant à relever. Il s’est agi d’une étude rétrospective portant sur les données issues des dossiers de 94 enfants de 0 à 14 ans diagnostiqués pour une tuberculose du 1er janvier 2015 au 31 décembre 2017 dans deux centres hospitaliers et universitaires d’Abidjan. Ainsi, la tranche d’âge de 0 à 4 ans était la plus représentée. La localisation pulmonaire était prédominante (71 %). Seulement 32 % des enfants ont été diagnostiqués bactériologiquement en ayant recours à la microscopie (87%) et au tubage gastrique (50 %). Le gène Xpert n’a été utilisé que 11 fois et a décelé 2 cas de résistance. La radiographie pulmonaire a été réalisée chez 87 enfants avec 91% d’anomalies observées. La co-infection TB/VIH était de 24 %. A l’issue de la prise en charge, 71 % ont été adressés dans un centre spécialisé pour la poursuite de leur traitement, 16 % sont décédés et 8,5 % étaient perdus de vue. Le diagnostic de la TBI demeure donc complexe. La vulgarisation des techniques moléculaires peut en améliorer le diagnostic.Mots-clés: Tuberculose, enfant, diagnostic, AfriqueEnglish Title: Diagnostic and clinical aspects of childhood tuberculosis: about 94 cases collected in hospitals in Abidjan, Côte d'Ivoire, from 2015 to 2017English AbstractBackground Childhood TB (CTB) remains massively underreported. The main reason for underreporting is the difficulties with diagnosis. Early diagnosis and management of CTB thus remain a constant challenge to overcome. This was a retrospective chart review study of 94 children aged 0 to 14 diagnosed with Tuberculosis, conducted from 1st January 2015 to 31st December 2017 in 2 university hospitals. For the 94 records collected, the age group from 0 to 4 years was the most represented. The pulmonary localisation was predominant (71%). Only 32% of children were bacteriologically confirmed using microscopy (87%) and gastric aspiration (50%). The GeneXpert was used only 11 times and detected 2 resistance cases. Chest X-ray was performed in 87 children with 91% anomalies observed. The TB/HIV coinfection rate was 24%. At the completion of the treatment and care, 71% were referred to a specialized clinic for the continuation of their treatment and care, 16% died and 8.5% were lost to follow-up. Diagnosis of CTB remains challenging. The popularization of molecular techniques may improve its diagnosis.Keywords: Tuberculosis, child, diagnosis, Afric

Knowledge, Attitudes, and Practices of HIV-Positive Adolescents Related to HIV/AIDS Prevention in Abidjan (Côte d’Ivoire)

Introduction. In sub-Saharan Africa, many adolescents living with HIV adopt behaviors and practices at risk of transmitting this infection. The aim of the study was to assess the knowledge, attitudes, and practices of HIV-positive adolescents regarding the transmission of HIV for the prevention of this disease. Methods. Knowledge Attitude Practical Survey (KAP) conducted from June 20 to August 22, 2018 in pediatrics at the University Hospital of Treichville. It included consenting HIV-positive adolescents followed up in the voluntary testing counseling unit. The variables studied related to sociodemographic aspects, knowledge, attitude, and practice relating to the transmission of HIV. The analysis was descriptive. Results. The active queue was 349 children, including 210 adolescents. Fifty adolescents (22 boys and 28 girls) participated in the study, a participation rate of 24%. The average age of the participants was 16 years (extreme 10 and 19 years). The respondent was an orphan (38%), a secondary school (58%), and separated living parents in 42%. He stated that he did not know he was infected in 62%, and that he had sex with at least one partner in 54%. He knew the modes of transmission and the means of prevention in 72% of the cases. He knew that an HIV-positive adolescent could transmit the disease in 68%, and that HIV/AIDS was incurable in 40%. 42% of respondents said that an infected person on ARVs was contagious. Twenty-nine respondents who had a partner said they had unprotected sex in 58%. All of the adolescents surveyed said that they did not talk to friends and family about HIV. Conclusion. The level of knowledge, attitude, and practice of HIV-positive adolescents regarding HIV/AIDS transmission is insufficient. We suggest setting up a therapeutic HIV/AIDS education program for these adolescents