PULMONARY TUBERCULOSIS IN GUINEA-BISSAU - CLINICAL AND BACTERIOLOGICAL FINDINGS, HUMAN-IMMUNODEFICIENCY-VIRUS STATUS AND SHORT-TERM SURVIVAL OF HOSPITALIZED-PATIENTS

Objective: To study tuberculosis patients in Guinea-Bissau with regard to clinical findings, bacteriologically verified diagnosis, human imm unodeficiency virus (HIV) status and short term survival. Design: 763 consecutive patients referred to the tuberculosis clinic with pulmonar y symptoms underwent clinical examination and Ziehl-Neelsen sputum mic roscopy, Sputum for culture of mycobacteria on Lowenstein-Jensen mediu m was collected from all hospitalized patients, who were also screened by enzyme linked immunosorbent assay for the presence of HIV-1 and HI V-2 antibodies, HIV-positivity was confirmed by Western blot. Results: 350 patients were diagnosed with tuberculosis and hospitalized, Adequ ate sputum samples were obtained from 301 patients, of whom 184 (61%) were positive on direct microscopy and the remaining 116 patients were diagnosed from clinical findings, Mycobacterium tuberculosis was cult ured from 184 patients and M. avium in 16 patients, whereas in 101 pat ients the culture was negative, HIV-1 antibodies were found in 3.0%, H IV-2 antibodies in 16.4%, and dual infections in 2.0%, These figures, however, did not differ significantly from those of randomly selected age and sex matched controls, The prevalence of HIV-antibodies was sta tistically as common in patients with culture verified tuberculosis as in patients with clinically defined tuberculosis, Clinical acquired i mmunodeficiency syndrome was commonly diagnosed (80/301 patients) but significantly more often in HIV-positive, culture-positive tuberculosi s patients, as were weight loss and lymphadenopathy, There was no stat istical difference in short-time survival rate between the various pat ient groups. Conclusion: The diagnostic criteria applied, which are ge nerally used in developing countries, identified most patients with pu lmonary tuberculosis; however, a substantial number of patients are tr eated for tuberculosis without definite diagnostic criteria, The preva lence of HIV-infection was high but statistically no significant diffe rence was demonstrated between the patient groups, controls and patien ts hospitalized for diseases other than tuberculosis.