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Missed Opportunities for Diagnosing Bacilliferous Pulmonary Tuberculosis by Optical Microscopy versus GeneXpert MTB/RIF in Endemic Areas

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Advances in Infectious Diseases 2023年第4期13卷 652-659页

作者： Aba Yapo Thomas Nassoué Dobré Olivia Yéo Liomehin Monemo Pacome Yapo Matine Tatiana achi hoboueu vincent Department of Infectious and Tropical Diseases University Hospital of Bouake Bouake Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pneumology University Hospital of Bouake Bouake Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouake Ivory Coast

Objective: To assess the missed opportunities from the diagnosis of bacilliferous pulmonary tuberculosis by optical microscopy compared to GeneXpert MTB/RIF between 2015 and 2019. Methods: This is a retrospective analysis of the diagnostic results of bacilliferous pulmonary tuberculosis in patients suspected of pulmonary tuberculosis at their first episode during the period. GeneXpert MTB/RIF (GeneXpert) and optical microscopy (OM) after Ziehl-Neelsen stained smear were performed on each patient’s sputum or gastric tubing fluid sample. Results: Among 341 patients suspected of pulmonary tuberculosis, 229 patients were declared bacilliferous tuberculosis by the two tests (67%), 220 patients by GeneXpert and 95 patients by OM, i.e. 64.5% versus 28% (p i.e. 58.5% of the positive cases detected by the two tests (134/229 patients) and 39.3% of the patients suspected of tuberculosis (134/341 patients). On the other hand, among 95 patients declared positive by OM, the GeneXpert ignored 9 (9.5%), i.e. 4% of all the positive cases detected by the two diagnostic tests (9/229 patients) and 3% of the patients suspected of tuberculosis (9/341 patients). The differences observed between the results of the two tests were statistically significant at the 5% threshold (p Conclusion: This study reveals missed diagnostic opportunities for bacilliferous pulmonary mycobacteriosis, statistically significant with optical microscopy than GeneXpert. The GeneXpert/optical microscopy couple could be a good contribution to the strategies for the elimination of pulmonary tuberculosis in sub-Saharan Africa.

关键词： Bacilliferous Pulmonary Tuberculosis Missed Opportunity GeneXpert MTB/RIF Optical Microscopy

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Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba Christian Yao Pacôme Monemo Richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula vincent achi vincent Kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké

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