Bovine tuberculosis (BTB) is widespread but poorly controlled in Africa and M. bovis is posing threats to human health. The risk of cattle handlers to M. bovis prevalence and public health significance of BTB in Cameroon were assessed. Slaughter inspection records from major cities revealed that BTB detection rates in cattle from 0.18% to 4.25% and BTB lesions were most common. Analyses of tissues and sera confirmed BTB in 31% (Ziehl-Neelsen), 51% (culture), and 60% (antibody detection) of test cattle. Among cattle handlers, 81.9% were aware of BTB, 67.9% knew that BTB is zoonotic, and 53.8% knew one mode of transmission but over 27% consumed raw meat and/or drank unpasteurized milk. Respondents who had encountered tuberculosis cases were more informed about zoonotic BTB (P < .05). Tuberculosis is prevalent in cattle destined for human consumption in Cameroon with serious public health implications. Targeted monitoring of infected animal populations and concerted veterinary/medical efforts are essential for control.

Objectives: To determine the prevalence of tuberculosis (TB) in Fako health District, to assess the effects of seasonal variation on the incidence of TB in the study area and to use sentinel analysis to predict areas of greatest infection. Design: A prospective cross sectional study based on laboratory investigations. Setting: Fako health District, South Western Carneroon. Results: The prevalence of TB was 23.3%.Tuberculosis was significantly more prevalent in males (12.6%) as compared with females (10.7%) (P = 0.034). TB prevalence was significantly different between age groups, with the highest number of cases recorded in the age group 21-30 (P = 0.002). When the health areas were compared, TB prevalence varied significantly (P = 0.001), with Limbe Town recording the highest number of TB cases. We recorded more TB cases in the wet season compared with the dry season and the difference was statistically significant (P = 0.000). There was a significant drop in the prevalence of TB over the study period (P = 0.000). Conclusion: This study is the first to report on the effects of season on the prevalence of TB in Cameroon. These findings will therefore provide additional useful base line data for setting up TB control strategies in Cameroon.

Bovine tuberculosis (TB) is an important neglected zoonosis in Cameroon, where many communities depend on their livestock for livelihood and the incidence of human TB and TB-HIV/AIDS co-infection are high and increasing annually. The aim of this study was to estimate the prevalence of bovine TB in cattle in the highlands of Cameroon. The magnitude and trend of detecting TB lesions in slaughtered cattle (1994 to 2010) and tuberculin skin tests (TST) in 2853 cattle (84 herds) of 39 livestock rearing communities were analysed. Of 129 165 slaughtered cattle inspected, 599 (0.46%; 95% CI: 0.43%-0.50%) showed suspected TB lesions among a total of 983 (0.76%; 95% CI: 0.71%-0.81%) identified pathologies. The monthly TB detection rates ranged from 0.30% (95% CI: 0.20%-0.40%) to 0.81% (95% CI: 0.64%-0.98%) and annual rates from 0.04% (95% CI: 0%-0.11%) to 1.46% (95% CI: 1.22%-1.69%). The rates were not affected (P < 0.05) by season and fluctuating peaks were also recorded. The comparative TST revealed that bovine TB was widely distributed in live cattle (4.67%; 95% CI: 3.89%-5.44%) and was higher (χ 2 = 17.50, P ≤ 0.001) in the Western highlands than Adamawa plateaux.Comparative TST bovine TB reactors were higher (P < 0.05) in cattle managed in semi-intensive and beef production systems compared to the others. Animals in small herds showed higher (χ 2 = 4.283, P = 0.038) rates than those in large herds. Bovine TB prevalence in exotic/upgraded cattle was comparable to that of the Red Bororo zebu but higher than the rates in Guadali (χ 2 = 4.971, P = 0.026) and White Fulani (χ 2 = 5.6, P = 0.018) zebus.Among the indigenous zebus, the rate was higher in Red Bororo than the Guadali (χ 2 = 6.244, P = 0.012) and White Fulani (χ 2 = 6.568, P = 0.010). Sex did not influence (χ 2 = 0.410, P = 0.522) bovine TB prevalence in this study but diagnosis of the disease was higher (χ 2 = 5.787; P = 0.016) among adult/older cattle than in younger animals. Further analysis of the TST responses revealed that atypical mycobacterial infections was widespread and 6.83% of tested animals showed positive reactions at both bovine and avian tuberculin injection sites and a strong association (χ 2 = 2.512; P = 0.113) between skin responses to both tuberculins. The study confirms that bovine TB is prevalent in live cattle and meat production abattoirs in Cameroon and we recommend strict a interpretation of TST results for maximum diagnosis of the disease in the local environment. A need for comprehensive investigation of the molecular epidemiology, zoonotic risks and the public health importance of bovine TB in Cameroon cannot be overemphasised.

This work was carried out in collaboration between all authors. Author SN drafted the protocol, carried out most of the bench work, analyzed data and wrote the first manuscript. Author BTP contributed in the identification of bacteria, supervised and made input to the manuscript. Author HDM is the scientist at the TB laboratory where sputum microscopy and culture were made. He ensured the standard procedure and closely supervised the bench work. Author ALN approved proposal, read the manuscript and made inputs. Author JCNA read the manuscript and made inputs. Author IAA is the senior scientist in charge of the TB lab in the Buea Regional Hospital. She designed the study, approved the protocol supervised and contributed in writing the manuscript.

BackgroundData on the levels of resistance of Mycobacterium tuberculosis complex (MTBC) strains to first line anti-tuberculosis drugs in Cameroon, and on the species of MTBC circulating in the country are obsolete. The picture about 10 years after the last studies, and 6 years after the re-organisation of the National Tuberculosis (TB) Control Programme (NTBCP) is not known.MethodsThe study was conducted from February to July 2009 in the West and Centre regions of Cameroon. A total of 756 suspected patients were studied. MTBC species were detected by the standard Ziehl-Neelsen staining method. Bacterial susceptibility to the first line drugs [isoniazid (INH), rifampicin (RIF), ethambutol (EMB) and streptomycin (SM)] were performed on cultures using the indirect proportion method. MTBC species were identified by standard biochemical and culture methods.ResultsOf the 756 suspected patients, 154 (20.37%) were positive by smear microscopy. Of these, 20.77% were HIV patients. The growth of Mycobacterium was observed with the sputa from 149 (96.75%) subjects. All the isolates were identified as either M. tuberculosis or M. africanum. Among these, 16 (10.73%) were resistant to at least one drug (13.3% for the West region and 8.1% for the Centre). The initial resistance rates were 7.35% for the Centre region and 11.29% for the West region, while the acquired resistance rates were 16.66% (1/6) for the Centre region and 23.07% (3/13) for the West. Within the two regions, the highest total resistance to one drug was obtained with INH and SM (2.68% each). Multidrug-resistance (MDR) was observed only in the West region at a rate of 6.67%. No resistance was recorded for EMB.ConclusionsM. tuberculosis and M. africanum remain the MTBC species causing pulmonary TB in the West and Centre regions of Cameroon. Following the re-organisation of the NTBCP, resistance to all first line anti-TB drugs has declined significantly (p < 0.05 for West; and p < 0.01 for Centre) in comparison to previous studies. However, the general rates of anti-TB drug resistance remain high in the country, underscoring the need for greater enforcement of control strategies.

BackgroundExtra-pulmonary tuberculosis (EPTB) is defined as any bacteriologically confirmed or clinically diagnosed case of TB involving organs other than the lungs. It is frequently a diagnostic and therapeutic challenge with paucity of data available. The aim of this study was to assess the prevalence of bacteriologically confirmed EPTB; to determine the most affected organs and to evaluate the therapeutic outcome of EPTB patients treated under program conditions in the littoral region of Cameroon.MethodsA descriptive cross-sectional laboratory-based epidemiological survey was conducted from January 2016 to December 2017 and 109 specimens from 15 of the 39 diagnosis and treatment centers in the littoral region were obtained.Two diagnostic methods (Gene Xpert MTB and culture (LJ and MGIT) were used for EPTB diagnosis. Determine HIV1/2 and SD Biolinewere used for HIV diagnosis. Confirmed EPTB cases were treated following the national tuberculosis guide.ResultsThe prevalence of bacteriologically confirmed EPTB was 41.3% (45). All 45 cases were sensitive to rifampicin. Males were predominately more infected [26 (57.8%)] likewise the age group 31–45 years with 15 (33.3%) cases. The overall prevalence for HIV was 33.6% (36). HIV infection was present in 28.9% (13) of patients with EPTB. The most affected sites with EPTB were: Lymph nodes (66.5%), pleural cavity (15.6%), abdominal organs (11.1%), neuromeningeal (2.2%), joints (2.2%) and heart (2.2%). Overall, 84.4% of the study participants had a therapeutic success with males responding better 57.9% (p = 0.442). Therapeutic success was better (71.7%) in HIV negative EPTB patients (p = 0.787).ConclusionThe prevalence of bacteriologically confirmed EPTB patients treated under program conditions in the littoral region of Cameroon is high with a therapeutic success of 84.4% and the lymph nodes is the most affected site.

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.

An epidemiological study was carried out to determine the Mycobacterium bovis strains causing bovine tuberculosis (TB) in cattle in North West Cameroon. Suspected TB lesions from slaughtered cattle were cultured on Lowenstein-Jensen and Middlebrook 7 H9 media to isolate mycobacteria agents for molecular genotyping using deletion analysis and spoligotyping. PCR-based genomic deletion typing showed that 54 of 103 tubercle bacilli isolated from cattle tissue were M. bovis strains and the African 1 clonal complex was widespread in affected cattle. Spoligotyping analysis revealed a closely related group of five M. bovis strains. SB0953, the dominant spoligotype pattern, and four new patterns identified as SB2161, SB2162, SB2663 and SB2664 according to the www.Mbovis.org international spoligotype database were identified. These spoligotypes were similar to other M. bovis strains recovered from bordering regions and other parts of Africa. The findings provided useful facts on the zoonotic risks of bovine TB and overwhelming evidence of the significance of M. bovis infection to human TB in the North West Region of Cameroon. The study revealed that bovine TB was widespread in cattle destined for human consumption and also has important implications for the control of TB in animals and humans in Cameroon.