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K Horo, A N'Gom,
B Ahui,
C Brou-Gode,
J-C Anon,
A Diaw,
P Bemba,
K Foutoupouo,
H Djè Bi,
P Ouattara,
B Kouassi,
N Koffi,
E Aka-Danguy
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ABSTRACT: In countries where tuberculosis is endemic, the main differential diagnosis for pleural infection by common bacteria is pleural tuberculosis.
The purpose of our study was to determine the differences between pleural infection by common bacteria and that caused by pleural tuberculosis.
Our study was a retrospective analysis and compared the characteristics of confirmed pleural infection by common bacteria (PIB) and that due to pleural tuberculosis (PT).
For the PIB, the signs evolved for 2.4 ± 1.4 weeks versus 5.6 ± 2.2 weeks for the PT (P=0.01). In multivariate analysis, for PIB the onset of symptoms was more abrupt (OR=3.8 [1.5; 9.9]; P=0.01), asthenia was less frequent (OR=0.3 [0.1; 0.9]; P=0.03), pleural liquid was more purulent (OR=40.0 [15.0; 106.7]; P<0.01). The blood neutrophil count was more frequently raised in cases of PIB (OR=2.5 [1.2; 5.4]; P=0.02). Pneumothorax/hydropneumothorax was less frequent in PIB (OR=0.3 [0.1; 1.0]; P=0.04).
Clinical differences exist between pleural effusions caused by tuberculosis (TB) and those due to other bacterial infections. However, they are not sufficiently sensitive and therefore the search for the tuberculous bacillus must be systematic while waiting for implementation of new diagnostic tests for the organism.
Revue des Maladies Respiratoires 03/2012; 29(3):404-11. · 0.59 Impact Factor
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K Horo,
N B Koffi,
B A Kouassi,
V C Brou-Godé,
B J M Ahui,
Y Silué,
K Touré,
Z A Gnazé,
K M Kouakou, A N'gom,
E Aka-Danguy
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ABSTRACT: In Côte d'Ivoire, since April 2002, the antituberculous regime for category I patients (ARC-I) passed from 2RHZ/4RH to 2RHZE/4RH, without modification of the antituberculous regime for category II (ARC-II) for treatment of cases of the failures to respond to treatment with ARC-I (FARC-I) and patients with a relapse of tuberculosis (TR). The objective of this study was to determine the outcome of patients treated by ARC-II (2RHZES/1RHZE/5RHE).
This study was retrospective and compared outcomes during patient follow-up under ARC-II between 1999-2000 (period 1=267 cases) and 2004-2005 (period 2=434 cases). The ARC-II regime has been prescribed for 297 cases of FARC-I and 404 cases of TR.
The failure rate of the ARC-II regime was estimated to be 11.98% during the first period compared to 5.53% during the second (P<0.001). Among FARC-I cases, therapeutic failure was estimated to 20.54% versus 5.92% in TR group (P<0,001). We noted a positive sputum smear among FARC-I : 16.16% at the second month, 13.13% to the third month and 20.54% at the fifth month versus 4.20% at the second month, 1.48% to the third month and 5.92% at the fifth month within TB cases (P<0.001).
Management of failures to the ARC-I regime must be reviewed to prevent the development of multidrug resistant TB.
Revue des Maladies Respiratoires 11/2010; 27(9):1055-61. · 0.59 Impact Factor
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ABSTRACT: Tobacco smoking is a scourge that continues to increase in developing countries despite its known consequences. Is the population of the Ivory Coast sufficiently informed about the consequences of smoking? For this reason, we decided to evaluate the knowledge of the effects of smoking among the people of Abidjan.
To evaluate the knowledge of the effects of smoking in the population of Abidjan. To relate this knowledge to the educational level and smoking status.
We evaluated knowledge about smoking and its consequences as a function of educational level and smoking status in the population of Abidjan over the age of 15 years. This was undertaken in 3 months, from November 2005 to January 2006, in the two busiest communes in Abidjan. The minimum number of persons required was 1152 but, in fact, we interviewed 1409.
The prevalence of smoking was 36.5% with a predominance of males (sex ratio = 3:11). They were mainly young with a mean age of 27.44 years. This population's main sources of information on the ill effects of smoking were the mass media. In general, the subjects did not have a good understanding of smoking and its consequences. With regard to the diseases related to smoking, bronchial carcinoma and cardiovascular disorders were the best known, in 53.1 and 18.1%, respectively. With regard to the components of tobacco, nicotine was the best known (92.6%). Knowledge was related to the level of education: the subjects of a higher educational level were the most knowledgeable about the consequences of smoking. As a result, these subjects were less attached to smoking than the less educated.
The consequences of smoking are poorly understood by the general population. With regard to the level of education, the better educated had a better understanding of the effects of smoking and were also those who smoked the least.
Revue des Maladies Respiratoires 03/2010; 27(3):226-31. · 0.59 Impact Factor
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B Kouassi,
K Horo,
B Vilasco,
N Koffi,
Y Kouamé,
B Ahui,
C Gode, A N'Gom,
E Aka-Danguy,
M Tchramran,
A Kamagaté
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ABSTRACT: We describe three cases of Lyell syndrome - toxic epidermal necrolysis - occurring in patients under the respiratory service of CHU de Cocody in Abidjan in the Ivory Coast, who were undergoing anti-tuberculous (TB) chemotherapy. All three were adult males who were HIV-positive, but none of them were receiving anti-retroviral treatment. They were on standard anti-TB treatment; rifampicin, isoniazid, pyazinamide and ethambutol. The lesions appeared early during their treatment for TB (14, 20 and 45 days). The patients were on no other medication that might have caused Lyell's syndrome except one who had been on cotrimoxasole for 6 months without complications. Despite admission to the acute care facility and appropriate care two of the three patients died.
Revue des Maladies Respiratoires 03/2010; 27(3):247-50. · 0.59 Impact Factor
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ABSTRACT: Community-acquired pneumonia (CAP) is the second leading cause of hospitalization in the respirology department in Abidjan after tuberculosis. Frequently associated with HIV infection, it has a high mortality rate of about 20% to 30%. The aim of this study is to identify the specificities and severity factors associated with bacterial CAP (BCAP) outcome in HIV-positive patients.
The authors conducted a prospective and comparative preliminary study on two groups of patients: 29 HIV-positive patients with BCAP and 21 HIV-negative patients with BCAP. All of the patients were hospitalized for BCAP with symptoms of severity according to the usual score of severity.
The sociodemographic, clinical and paraclinical characteristics were similar in both groups. Failures and deaths were more frequent in the group with HIV infection. In particular, HIV infected patients with a body mass index under 18.5 and a rate of T CD4 lymphocytes lower than 200/mm(3) presented the least favourable evolution.
A more extensive study should help define the appropriate severity criteria for BCAP associated with HIV infection.
Revue de Pneumologie Clinique 07/2009; 65(3):137-42. · 0.24 Impact Factor
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ABSTRACT: Entamoeba histolytica, is a human pathogen which is endemic in tropical areas. The most common extra-intestinal locations for disease after the liver are pleural and pulmonary. Although the outcome of pleural and pulmonary amoebiasis is generally favourable, it is important to note that a significant proportion of patients do develop pleural and pulmonary after-effects. We report a case of pleural and pulmonary amoebiasis where the evolution of a massive pleural effusion and 3 associated liver abscesses was spectacular. The surgical management of pleural, pulmonary and liver amoebiasis is discussed.
Revue des Maladies Respiratoires 06/2009; 26(5):547-51. · 0.59 Impact Factor
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K Horo,
A B Kouassi,
B Z Tea,
L Assa,
V M Icthy,
A Folquet,
V C Godé,
B J M Ahui,
M Cardenat,
V Achi,
M N'dhatz-Sanogo,
J C Anon,
J M N'gouan, A N'gom,
N Koffi,
E Aka-Danguy
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ABSTRACT: Intratracheobronchial foreign bodies are common accidents in children. In developed countries, the removal of these intratracheobronchial foreign bodies is performed with flexible or rigid fiberoptic bronchoscopy. Resorting to surgery is rare. In the inadequate medical context described, suitable medical technical equipment doesn't exist. Removal alternatives are necessary in order to avoid sanitary evacuation which is not always within patients' means. In this study, the authors describe the removal of an intratracheobronchial foreign body opaque to X-rays with foreign body forceps. The forceps, passed through the orotracheal intubation probe, were guided by an image intensification system in a traumatology operating theatre.
Revue de Pneumologie Clinique 05/2009; 65(2):97-100. · 0.24 Impact Factor
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ABSTRACT: Recent studies on smoking conducted in the ivory coast have been sparse despite increasingly aggressive tobacco company campaigns. The purpose of this prospective study was to examine the influence of medical specialty on patient knowledge, attitude and smoking behavior among people consulting three university hospitals in Abidjan. The inquiry was performed with a questionnaire concerning a comparative series of 180 subjects (90 patients in each sample). Overall, the series included 16.10% active smokers, 15.60% former smokers, and 68.30% non-smokers, with no difference between the groups. The well-known feature of smoking with friends was main reason cited for beginning smoking. Three quarters of patients (75.9%) had attempted to stop smoking. Information about smoking was obtained from the media. The hospital was involved little in acquiring knowledge about smoking. Type of specialist consultation (hospital units providing care for smoking-related disease or not) had little influence. Hospital units should become more involved in the anti-smoking campaign. Consultations on cessation of smoking should be instituted in a country with highly aggressive smoking advertisements.
Revue de Pneumologie Clinique 10/2004; 60(4):217-22. · 0.24 Impact Factor
