Résumé
Background and methodology - The delay in the diagnosis of H I V infection is a major obstacle to optimal care for this disease. To deal wit h I h is problem, we conducted this study among newly diagnosed HIV patients hospitalized in the Fann University Hospital Infectious Diseases Clinic in Dakar. The epidemiological, clinical, biological and outcome aspects are described and patient history reviewed. A qualitative socio-anthropological study was made to understand and describe the logic of the decision processes in the patient's search for treatment.
Results. - One hundred patients were included, with a mean age of 39.5 +/- 11.1 years and a sex-ratio: 1.08. The transmission wits mainly heterosexual (90%), and chronic diarrhea (64%) and/or chronic cough (66%) were the principal symptoms leading to diagnosis. The mean delay before diaonosis was 5 +/- 4.27 months. The major opportunistic diseases were tuberculosis (44 cases) and infectious diarrhea (23 cases). Most patients were diagnosed at the AIDS stage (97%) and the death rate was 30% among hospitalized patients after admission. Sixty-eight percent of patients had consulted at least three times, generally a "traditional practitioner", at first and 43% had been hospitalized at least once. The qualitative investigation revealed that the "representation" or the "feeling of severity" of the disease were the principal justifications for consulting the "traditional practitioner" or the physician, respectively.
Conclusion. - Better information for health workers and global population is necessary for an earlier diagnosis of HIV infection in Dakar. (C) 2008 Elsevier Masson SAS. Tous droits reserves.