TITLE:
Prevalence of Pulmonary Tuberculosis and Associated Factors among Patients Admitted to the Amissa Bongo University Hospital Center in Franceville, Gabon
AUTHORS:
Thiéry Ndong Mba, Cedric Sima Obiang, Hilaire Moundounga Kenguele, Arnaud Brice Pambo-Pambo, Iris Kévin Ivala Zogo Mba, Ulrich Lowens Onkassa Sah, Louis-Clement Obame Engonga, Cyrille Bisseye, Patrick Mickala
KEYWORDS:
Prevalence, Pulmonary Tuberculosis, Ziehl-Neelsen Rapid Acid Staining, GeneXpert, CHURAB, Franceville, Gabon
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.11 No.7,
July
20,
2023
ABSTRACT: Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77; 95% CI: [4.4; 519.7] p = 0.001*), fever (Adjusted OR = 4.83; 95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2; 95% CI: 12.2 [2.5; 5.9] p = 0. 002*), smoking (Adjusted OR = 9.83; 95% CI: [1.78; 54.24] p = 0.037), HIV infection (Adjusted OR = 4.63; 95% CI: [1.25; 17.1] p = 0.022), cough (Adjusted OR = 4.31; 95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6; 95% CI: [19.4; 55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84; 95% CI: [3.18; 36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.