[Epidemiology of tuberculosis in Abidjan, Ivory Coast: effects of HIV infection]

Despite the rising morbidity and mortality of tuberculosis in patients with HIV infection, epidemiology of tuberculosis in the Ivory Coast remains under-documented. The aim of this retrospective study of 1638 cases of tuberculosis diagnosed in the Pneumology Department of the Abidjan University Hospital was to collect current epidemiological data. From 1986 to 1992, a total of 4631 patients were hospitalized at University Hospital-Abidjan. Clinical and serological tests to detect HIV infection were performed in 982 patients. During hospitalization all patients received the same treatment for tuberculosis (2RHZ/4RH). Tuberculosis accounted for 42 p. 100 of diagnoses with a prevalence of 234 patients per year and a rate of increase was 4.5 p. 100 per year. Most patients were between the ages of 20 and 40 years (59 p. 100) and of male sex (72 p. 100). Overall HIV seroprevalence was 44.5 p. 100 with a rate of increase of 4.4 p. 100 per year. The proportion of patients tested for HIV grew from 11 p. 100 to 98 p. 100 over the seven-year study period and infection rates were consistently higher in men than in women (sex ratio: 3 to 1). The mean percentage of extrapulmonary or disseminated tuberculosis was sharply higher in the last three years of study (from 23.5 p. 100 to 46 p. 100 after 1989). This study demonstrates that seroprevalence rate has increased and that this increase has been correlated with a rising incidence of lethal and extrapulmonary tuberculosis.