Drug resistance profiles of Mycobacterium tuberculosis complex and factors associated with drug resistance in the Northwest and Southwest Regions of Cameroon.

Pascal N Atanga,Henry D Meriki,Kukwah A Tufon,Damian N Anong,Theresa Nkuo-Akenji,Fidelis Cho-Ngwa,Irene N Ane-Anyangwe

doi:10.1371/journal.pone.0077410

Abstract

BackgroundAnti-tuberculosis drug resistance continues to be a major obstacle to tuberculosis (TB) control programmes with HIV being a major risk factor in developing TB. We investigated anti-TB drug resistance profiles and the impact of socioeconomic as well as behavioural factors on the prevalence of TB and drug resistance in two regions of Cameroon with such data paucity.MethodsThis was a hospital-based study in which 1706 participants, comprising 1133 females and 573 males consecutively enrolled from selected TB and HIV treatment centres of the Northwest and Southwest regions. Demographic, clinical and self-reported risk behaviours and socioeconomic data were obtained with the consent of participants using questionnaires. Culture and drug resistance testing were performed according to standard procedures.ResultsThe prevalence of resistance to at least one anti-TB drug was 27.7% and multi-drug resistance was 5.9%. Smoking, concurrent alcohol consumption and smoking, being on antiretroviral therapy for ≤ 12 months and previous household contact with TB patient were independently associated with tuberculosis prevalence, while only previous tuberculosis infection was associated with drug resistance in a univariate analysis.ConclusionThe study showed a high prevalence of drug resistance TB in the study population with only previous TB infection associated with drug resistance in a univariate analysis. It also provides evidence in our context, of the role of alcohol and smoking in increasing the risk of developing TB, which is more likely in people living with HIV/AIDS. Therefore, it is important for public health authorities to integrate and intensify alcohol/smoking abstention interventions in TB and HIV control programs in Cameroon.

Highlights

Efforts to curb TB by the logical application of existing strategies such as early detection and treatment following the direct observed treatment strategy (DOTS), have met with only limited success, slowing the rate of increase but failing to make significant progress toward the goal of tuberculosis elimination [1]
Participants were TB and/or HIV diagnosed cases sent for TB treatment or HIV positive cases qualified for antiretroviral therapy (ART) or on clinical surveillance
The majority (55.9%) of the participants were between the ages of 30-45 years, while 23.1% and 21% of the population were between the 18-29 years and > 45 years old respectively

Summary

Introduction

Efforts to curb TB by the logical application of existing strategies such as early detection and treatment following the direct observed treatment strategy (DOTS), have met with only limited success, slowing the rate of increase but failing to make significant progress toward the goal of tuberculosis elimination [1]. The. Anti-tuberculosis drug resistance continues to be a major obstacle to tuberculosis (TB) control programmes with HIV being a major risk factor in developing TB. Conclusion: The study showed a high prevalence of drug resistance TB in the study population with only previous TB infection associated with drug resistance in a univariate analysis. It provides evidence in our context, of the role of alcohol and smoking in increasing the risk of developing TB, which is more likely in people living with HIV/ AIDS. It is important for public health authorities to integrate and intensify alcohol/smoking abstention interventions in TB and HIV control programs in Cameroon

Methods

Results

Discussion

Conclusion