Abstract
BackgroundIn the 1990s, resistance rates of 15% for streptomycin-resistance and 0.6% for multidrug-resistance (MDR) were reported from the Central Region of Cameroon. This work assesses drug resistant tuberculosis in this region 12 years after reorganization of the National Tuberculosis Control Program (NTCP).MethodsThis cross-sectional study was conducted from April 2010 to March 2011 in Jamot Hospital in Yaoundé, Cameroon. Only patients with smear positive pulmonary tuberculosis were included. Sputa were cultured and subsequently underwent drug susceptibility testing (DST). All consenting individuals were tested for their HIV status.ResultsA total of 665 smear positive pulmonary tuberculosis patients were enrolled. The HIV prevalence was 28.5% (95%CI [25.2–32.1]). Of the 582 sputa that grew Mycobacterium tuberculosis complex species, DST results were obtained for 576. The overall resistance rate was 10.9% (63/576). The overall resistance rates for single drug resistance were: isoniazid-resistance 4.7% (27/576), streptomycin-resistance 3.3% (19/576), rifampicin-resistance 0.2% (1/576), kanamycin-resistance 0.2% (1/576) and ofloxacin-resistance 0.2% (1/576). The MDR rate was 1.1% (6/576) and no extensively drug resistant tuberculosis (XDR) was detected.ConclusionsThe data show that reorganization of the NTCP resulted in a strong decrease in streptomycin-resistance and suggest that it prevented the emergence of XDR in the Central Region of Cameroon.
Highlights
Tuberculosis, the second leading cause of death among infectious disease worldwide, is responsible for an estimated 1.4 million deaths each year [1]
WHOs recommended approach to tuberculosis-care is the STOP TB Strategy, which is based on Directly Observed Treatment Short-course (DOTS)
This study site is among the 223 diagnostic and treatment centres for tuberculosis patients coordinated by the Cameroon National Tuberculosis Control Program
Summary
Tuberculosis, the second leading cause of death among infectious disease worldwide, is responsible for an estimated 1.4 million deaths each year [1]. WHOs recommended approach to tuberculosis-care is the STOP TB Strategy, which is based on Directly Observed Treatment Short-course (DOTS) This approach has been shown to be able to control the spread of drug resistant-tuberculosis in the Americas [2,3] and Asia [4,5]. Effective control of tuberculosis is threatened by the emergence of multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis [6] highly prevalent in Southern Africa [1] [7] This raises the question of the presence of XDR-tuberculosis in other areas of sub-Saharan Africa, where the number of tuberculosis cases reported might be limited due to infrastructural difficulties. This work assesses drug resistant tuberculosis in this region 12 years after reorganization of the National Tuberculosis Control Program (NTCP)
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