Pre-treatment Loss to Follow-up in Patients with Confirmed Pulmonary Tuberculosis in Niamey, Niger

Aims and Scope: Pre-treatment loss to follow-up (PTLFU) represents a major problem that hinders the management of tuberculosis. This paper focuses on determining the prevalence of lost to follow-up patients diagnosed with smear-positive pulmonary tuberculosis (SPPT) who are referred to other TB screening and treatment centers (TBSTC). Methods: This was a prospective, descriptive, and analytical study conducted over a six-month period between March and August 2019, in patients diagnosed with smear-positive pulmonary tuberculosis at NCFATRD and referred to Niamey and Tillaberi centers. A chi-square test was used with a significance level of P ≤ 0.05. Findings: 743 patients were diagnosed with SPPT, and 346 were referred to the TBSTC located in Niamey and Tillaberi cities. The prevalence of loss to follow-up before treatment in both Niamey and Tillaberi cities was 14.45% (50/343). Males represented 82% (41) of the cases with a sex ratio of 4.55. The mean age of the patients was 41.04 years. Patients not attending school, as well as those with primary school education, represented the majority of cases, accounting for 30% each. The majority of PTLFU (95.66%) were new cases of TB. Nearly half (42%) of PTLFU had traveled a distance of 6 to 15 km to receive TB screening. During the phone call follow up, only 12 patients (24%) were reached, of whom 7 (14%) were deceased. Conclusion: The prevalence of PTLFU remains high. Therefore, reinforcing the research of lost to follow-up patients is necessary to enhance tuberculosis control and management

Pre-Treatment Loss to Follow-up of Patients with Bacilloscopy-Confirmed Pulmonary Tuberculosis in the National Center for the Fight Against Tuberculosis and Respiratory Diseases in Niamey

Context: Pre-treatment loss of follow-up (PTLFU) represents a major problem that hinders the management of tuberculosis. The objective of this study is to determine the prevalence of lost to follow-up patients diagnosed with smear-positive pulmonary tuberculosis (SPPT) and referred to other TB screening and treatment centers (TBSTC). Method: This was a prospective, descriptive and analytical  study conducted over a six month between March and August 2019, in patients diagnosed with smear-positive pulmonary tuberculosis at NCFATRD and referred to Niamey and Tillaberi centers. The chi-square text was used with a significance level of P ≤ 0.05. Results: 743 patients were diagnosed with SPPT, and 346 were referred to the TBSTC located in Niamey and Tillaberi cities. The prevalence of loss of follow-up before treatment in both Niamey and Tillaberi cities was 14.45% (50/343). Male represented 82% (41) of the cases with a sex ratio of 4.55. The mean age of our patients was 41.04 years. Patients not attending school and those with primary education represented the majority with 30% each. The majority of PTLFU (95.66%) were new cases of TB.  Nearly half (42%) of PTLFU had traveled a distance of 6 to 15 km to get the TB screening. During the phone call follow up, we were able to reach only 12 patients (24%) of which 7 (14%) were deceased. Conclusion : the prevalence of PTLFU is high, therefore there is a need to reinforce the research of lost to follow up patients in order to improve tuberculosis control and management

Tuberculosis in Vaccinated versus Unvaccinated Children with BCG Vaccine in Niamey: Epidemiological, Diagnostic and Outcome Aspects

Introduction: Tuberculosis remains a public health problem worldwide. The BCG vaccination is one of the response means. The objective of this work was to study the impact of BCG vaccination on morbidity and mortality related to childhood tuberculosis in Niamey. Patients and methods: It was a multicenter prospective and comparative study from January to September 2017 in two-referral hospital centers of Niamey and the National Anti-Tuberculosis Center. The study population consisted exclusively of children aged 0 to 15 years old suffering from tuberculosis. Epidemiological, diagnostic, and evolving aspects in vaccinated and unvaccinated children were studied. Statistical tests used were Pearson's Chi² and Fisher's exact test (p <0.05). Results: Ninety-one children were studied. The BCG vaccination rate was 60.4%. The mean age of children was 6 years 11 months [3 months-15 years]. Children under 2 years of age were less affected (11%) in vaccinated children than in unvaccinated children (3.2%). No association was found between the duration of tuberculosis signs (p = 0.37), expression of tuberculin skin test (p = 0.43), and the children's BCG vaccination status. On the other hand, there was a significant link between vaccination status and the occurrence of complications (p = 0.014), and death risk (p = 0.003). Conclusion: This study shows that children’s BCG vaccination status correlates with some aspects of tuberculosis. Unvaccinated children have a significantly higher risk of complications and death from TB

Tuberculosis in Vaccinated versus Unvaccinated Children with BCG Vaccine in Niamey: Epidemiological, Diagnostic and Outcome Aspects

Introduction: Tuberculosis remains a public health problem worldwide. The BCG vaccination is one of response means. The objective of this work was to study impact of BCG vaccination on morbidity and mortality related to childhood tuberculosis in Niamey. Patients and methods: It was a multicenter prospective and comparative study from January to September 2017 in two-referral hospital centers of Niamey and the National Anti-Tuberculosis Center. The study population consisted exhaustively of children aged 0 to 15 years old suffering from tuberculosis. Epidemiological, diagnostic and evolving aspects in vaccinated and unvaccinated children were studied. Statistical tests used were Pearson's Chi² and Fisher's exact test (p <0.05). Results: Ninety-one children were studied. The BCG vaccination rate was 60.4%. The mean age of children was 6 years 11 months [3 months-15 years]. Children under 2 years of age were less affected (11%) in vaccinated children than in unvaccinated children (3.2%). No association was found between duration of tuberculosis signs (p = 0.37), expression of tuberculin skin test (p = 0.43), and the children's BCG vaccination status. On the other hand, there was a significant link between vaccination status and the results of microscopic examination of sputum or gastric fluid (p = 0.02), occurrence of complications (p = 0.014) and death risk (p = 0.003). Conclusion: This study shows that children’s BCG vaccination status interferes with some aspects of tuberculosis. Therefore, fighting against tuberculosis must be intensified, through combination of many strategies including vaccination

Tuberculosis in Vaccinated versus Unvaccinated Children with BCG Vaccine in Niamey: Epidemiological, Diagnostic and Outcome Aspects

Introduction: Tuberculosis remains a public health problem worldwide. The BCG vaccination is one of response means. The objective of this work was to study impact of BCG vaccination on morbidity and mortality related to childhood tuberculosis in Niamey. Patients and methods: It was a multicenter prospective and comparative study from January to September 2017 in two-referral hospital centers of Niamey and the National Anti-Tuberculosis Center. The study population consisted exhaustively of children aged 0 to 15 years old suffering from tuberculosis. Epidemiological, diagnostic and evolving aspects in vaccinated and unvaccinated children were studied. Statistical tests used were Pearson's Chi² and Fisher's exact test (p <0.05). Results: Ninety-one children were studied. The BCG vaccination rate was 60.4%. The mean age of children was 6 years 11 months [3 months-15 years]. Children under 2 years of age were less affected (11%) in vaccinated children than in unvaccinated children (3.2%). No association was found between duration of tuberculosis signs (p = 0.37), expression of tuberculin skin test (p = 0.43), and the children's BCG vaccination status. On the other hand, there was a significant link between vaccination status and the results of microscopic examination of sputum or gastric fluid (p = 0.02), occurrence of complications (p = 0.014) and death risk (p = 0.003). Conclusion: This study shows that children’s BCG vaccination status interferes with some aspects of tuberculosis. Therefore, fighting against tuberculosis must be intensified, through combination of many strategies including vaccination