[Multi-drug resistance of tuberculosis: 81 patients monitored in an Ivory Coast pneumology unit]

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.