La tuberculose et ses aspects épidémio-cliniques et évolutifs au service de Médecine Interne de l’Hôpital National Donka (Guinée)

Abstract

Introduction: Tuberculosis is an infectious disease with human-to-human transmission linked to Koch's bacillus (BK). It is one of the infectious diseases causing the most deaths in the world. Our objective was to determine the epidemiological, clinical and progressive aspects of tuberculosis in the Internal Medicine department of the Donka National Hospital. Material and Methods: This was a retrospective descriptive study covering the medical records of patients in the Internal Medicine Department (SMI) of the Donka National Hospital over a study period ranging from January 2017 to June 2023. We included all files of patients aged over 15 years during the study period and presenting signs of tuberculosis. Results: During the study period 145 patients with 81 (55.86%) men and 64 (44.14%) women were collected. The average age of our patients was 44 years with a male predominance, i.e. a sex ratio of 1.26. Seventy-five patients (51.72%) were human immunodeficiency virus (HIV) infected patients. Tuberculosis was multifocal in 69 (47.59%) cases, neuromeningeal in 31 (21.38%) cases and pulmonary in 45 (31.03%) cases. The clinical symptoms were dominated by the deterioration of the general condition and fever in all our patients, vomiting in 61 (42.07%) patients. The most frequent radiological signs were pulmonary nodules (53.36%) and deep lymphadenopathy (36.42%). Tuberculosis was confirmed by expert gene in 38.27% of cases. The intradermal reaction to tuberculin was positive in 42% of cases. The evolution was favorable in 68% of patients, towards a worsening in 32% of cases with a death rate of 26%. Conclusion: Tuberculosis still remains a public health problem in our regions, especially since the advent of HIV/AIDS. This condition mainly concerns men in our context.