Drug Sensitivity and Molecular Diversity of M. tuberculosis in Cameroon: A Meta-analysis

Abstract

Tuberculosis (TB) represents one of the most challenging threats to global human health. M. tuberculosis causes about 8.8 million new cases of active tuberculosis and 1.1 million deaths annually. According to Cameroon's National TB Control Program (NTBCP), tuberculosis still remains a major public health problem: an important cause of mortality and morbidity, with a negative impact on the socioeconomic condition of the population. This paper is a meta-analysis review of the molecular diversity and drug sensitivity trends to first line TB drugs and the threat of multi-drug resistant (MDR) strains to the TB control programs in Cameroon. A very large selection of papers from the last 20 years was done through Google, Google scholar, Pub Med using as keys words 'Mycobacterium tuberculosis, tuberculosis, resistance to first and second line drugs, molecular typing, Cameroon'. The paper to be selected for analysis must have dealt with at least one of the key words and must have been carried out in at least one of the regions of Cameroon. The selected paper was red and the required information for the review was then extracted. Investigations of genetic polymorphism of M. tuberculosis complex strains from humans in Cameroon has shown M. tuberculosis sensu stricto to be the predominant agent of TB cases, with the preponderance of the LAM10 family genotype and large shift of M. africanum. The resistance to all first line anti-TB drugs has declined significantly, however, the general rates of anti-TB drug resistance remain high in some regions, underscoring the need for greater enforcement of control strategies in the country.

Tuberculosis Chemotherapy Outcome in the Littoral Region of Cameroon: A Meta-analysis of Treatment Success Rate between 2014 and 2016

“…Besides, the pooled values of cure rates were below the threshold of 85% defined by the WHO [ 15 ]. The appearance and spread of multidrug-resistant strains can also be explained by this finding as they have been reported in the Littoral Region by many authors [ 4 , 6 , 16 ]. Also, this problem of multidrug resistance can become a bigger threat in the following years in the region due to high rates of cross-border and between-region migrations [ 17 ].…”

“…Since the achievement of full coverage of TB in Cameroon in 2002, the National Control Programme of TB has continuously improved its fight through policy and many key strategies including the implementation of surveillance system, a faster management through 248 diagnostic and treatment centers (DTCs) distributed over the territory. Also, there was an increase in full adherence to treatment as well as the proportion of cured patients through the adoption of directly observed treatment strategy (DOTS) based on rifampicin used as first-line treatment [ 2 – 4 ]. Recently, the National Control Programme validated the utilization of genotyping technology in the Littoral Region referred to as GeneXpert TB test for the detection of resistance to rifampicin [ 5 ].…”