EPIDEMIOLOGICAL AND CLINICAL PROFILE OF HIV/TB CO-INFECTED PATIENTS IN TWO DEPARTMENTS OF THE NGOUNIÉ PROVINCE IN SOUTHERN GABON

Background: The onset of the HIV-AIDS pandemic has contributed to the rapid progression of latent tuberculosis to active multidrug-resistant tuberculosis in infected individuals. However, to our knowledge, there are no published reports on TB-HIV co-infection in the provinces of Gabon. It is in this context that this study aimed to investigate the epidemiological and clinical profile of HIV/TB co-infected patients in two departments of the Ngounié province in southern Gabon. Material and methods: In order to establish this profile, two diagnostic methods, namely microscopic examination and GeneXpert MTB/RIF, were performed on two sputum samples from each patient suspected of having tuberculosis (TB). Results: One thousand one hundred and thirty-two (1132) patients were included in this study. With a sex ratio of 1.23, there was a male predominance with 624 or 55.12% of males and 508 or 44.88% of females suspected of having TB. 268 or 23.67% of patients were diagnosed as TB positive (HIV-/TB+), 73 or 6.4% were HIV+/TB+ co-infected, and 52 or 4.6% of TB positive patients had an unknown HIV status HIV positive status had a prevalence of 25.2% or 286 patients. During 2018 and 2019, while females were more infected with HIV 15.55% (n=176) compared to males 9.72% (n=110), TB affected more males 56.7% (n=115) than females 43.3% (n=88). Co-infection affected more men with 47 patients or 64.38% than women with 26 or 35.62%. We observed a change in the prevalence of HIV to 163 cases, i.e. 57%, leading to an increase in the prevalence of HIV+/TB+ co-infection to 48 cases, i.e. 51.7%. The Douya-Onoye department recorded 72.6% (n=53) of co-infected patients compared to 27.4% (n=20) in the Tsamba-Magotsi department. All the co-infected patients had pulmonary tuberculosis, i.e. 100% (n=73), and in the mono-infected patients, pulmonary tuberculosis was found in 95.52% (n=256) of the cases, compared to 3.8% (n=12) of the patients with extra pulmonary tuberculosis. 341 patients, of which 78.6% (n=268) were mono-infected and 21.40% (n=73) co-infected, took antituberculosis treatment. Among the mono-infected, the therapeutic success was 21.64% (n=58), the number of lost to follow-up was 60.08% (n=161) and the number of deaths was 1.12% (n=3) while among the co-infected, the therapeutic success was 5.48% (n=4), the number of lost to follow-up was 78.08% (n=57) and the number of deaths was 6.85% (n=5). By locality, mortality was estimated at 62.5% (n=5) in co-infected patients versus 37.5% (n=3) in mono-infected patients. In the Douya-Onoye department, of which Mouila is the capital, tuberculosis caused 75% (n=6) of deaths and 25% (n=2) in the Tsamba-Magotsi department, of which Fougamou is the capital Conclusion: The results of this study show that HIV/TB co-infection is a major public health problem in the Ngounié province in particular and in Gabon in general.