[Extra-pulmonary tuberculosis in Antananarivo. Principal localizations and biological diagnosis]

We describe the state of extrapulmonary tuberculosis in the capital of Antananarivo, a city of high endemicity for tuberculosis but very low endemicity for HIV infection. The Laboratory of Mycobacteria in the Institut Pasteur of Madagascar had examined from August 94 to April 95, 543 pathological samples issued from 295 patients clinically suspected of extrapulmonary tuberculosis (64% male and 36% female). The diagnosis of tuberculosis was confirmed for 47.7% of the patients (141/295), using either the culture technique or the histopathological method: 93% of them had an unique localization whereas 7% had a double localization. The most frequent form encountered was the pleural localization (77.8%), followed by the lymphadenopathic form (8,4%) and the abdominal form (6.9%). The confirmation rate on biopsies was 67% by histopathological method compared to 55% by the culture. On the fluid samples, the confirmation rate was 20.9% using the culture. The agreement between histology and culture was 70.3%. Of the 138 strains identified, 135 were M. tuberculosis, 1 M. bovis and 2 environmental mycobacteria.