BACKGROUND: WHO/UNAIDS recommended that cotrimoxazole should be prescribed in Africa in HIV-infected adults with CD4 cell counts < 500 x 10 /l, while closely monitoring bacterial diseases in as many settings as possible. METHODS: Prospective cohort study, describing bacterial morbidity in adults receiving cotrimoxazole prophylaxis (960 mg daily) between April 1996 and June 2000 in Abidjan, Côte d'Ivoire. RESULTS: Four-hundred and forty-eight adults (median baseline CD4 cell count 251 x 10 /l) were followed for a median time of 26 months. The rates of overall bacterial diseases and of serious bacterial diseases with hospital admission were 36.8/100 person-years (PY) and 11.3/100 PY, respectively. Bacterial diseases were the first causes of hospital admissions, followed by non-specific enteritis (10.2/100 PY), acute unexplained fever (8.4/100 PY), and tuberculosis (3.6/100 PY). Among serious bacterial diseases, the most frequent were enteritis (3.0/100 PY), invasive urogenital infections (2.5/100 PY), pneumonia (2.3/100 PY), bacteraemia with no focus (2.0/100 PY), upper respiratory tract infections (1.6/100 PY) and cutaneous infections (0.6/100 PY). Compared with patients with baseline CD4+ cell counts >or= 200 x 10 /l, other patients had an adjusted hazard ratio of serious bacterial diseases of 3.05 (95% confidence interval, 2.00-4.67; < 0.001). Seventy-five bacterial strains were isolated during serious episodes including 29 non-, 14, 12 spp, and 12. DISCUSSION: Though with a medium-term rate half that of the short-term rate estimated under placebo before 1998 (26.1/100 PY), serious bacterial morbidity remains the first cause of hospital admission in adults receiving cotrimoxazole in this setting.
BACKGROUND: WHO/UNAIDS recommended that cotrimoxazole should be prescribed in Africa in HIV-infected adults with CD4 cell counts < 500 x 10 /l, while closely monitoring bacterial diseases in as many settings as possible. METHODS: Prospective cohort study, describing bacterial morbidity in adults receiving cotrimoxazole prophylaxis (960 mg daily) between April 1996 and June 2000 in Abidjan, Côte d'Ivoire. RESULTS: Four-hundred and forty-eight adults (median baseline CD4 cell count 251 x 10 /l) were followed for a median time of 26 months. The rates of overall bacterial diseases and of serious bacterial diseases with hospital admission were 36.8/100 person-years (PY) and 11.3/100 PY, respectively. Bacterial diseases were the first causes of hospital admissions, followed by non-specific enteritis (10.2/100 PY), acute unexplained fever (8.4/100 PY), and tuberculosis (3.6/100 PY). Among serious bacterial diseases, the most frequent were enteritis (3.0/100 PY), invasive urogenital infections (2.5/100 PY), pneumonia (2.3/100 PY), bacteraemia with no focus (2.0/100 PY), upper respiratory tract infections (1.6/100 PY) and cutaneous infections (0.6/100 PY). Compared with patients with baseline CD4+ cell counts >or= 200 x 10 /l, other patients had an adjusted hazard ratio of serious bacterial diseases of 3.05 (95% confidence interval, 2.00-4.67; < 0.001). Seventy-five bacterial strains were isolated during serious episodes including 29 non-, 14, 12 spp, and 12. DISCUSSION: Though with a medium-term rate half that of the short-term rate estimated under placebo before 1998 (26.1/100 PY), serious bacterial morbidity remains the first cause of hospital admission in adults receiving cotrimoxazole in this setting.
Authors: M-F Anaky; J Duvignac; L Wemin; A Kouakoussui; S Karcher; S Touré; C Seyler; P Fassinou; F Dabis; T N'Dri-Yoman; X Anglaret; V Leroy Journal: Bull World Health Organ Date: 2009-12-21 Impact factor: 9.408
Authors: Albert Minga; Christine Danel; Yao Abo; Lambert Dohoun; Dominique Bonard; Ali Coulibaly; Julien Duvignac; François Dabis; Roger Salamon; Xavier Anglaret Journal: Bull World Health Organ Date: 2007-02 Impact factor: 9.408
Authors: Eugène Messou; Xavier Anglaret; Julien Duvignac; Eric Konan-N'dri; Eric Komena; Joachim Gnokoro; Sophie Karcher; Anthony Tanoh; Thérèse N'dri-Yoman; Catherine Seyler Journal: AIDS Date: 2010-01-02 Impact factor: 4.177
Authors: N Alsaad; J A Dijkstra; O W Akkerman; W C M de Lange; D van Soolingen; J G W Kosterink; T S van der Werf; J W C Alffenaar Journal: Antimicrob Agents Chemother Date: 2016-06-20 Impact factor: 5.191
Authors: M Ortega; M Almela; A Soriano; F Marco; J A Martínez; A Muñoz; G Peñarroja; J Mensa Journal: Eur J Clin Microbiol Infect Dis Date: 2008-05-01 Impact factor: 3.267