Mycobacterium tuberculosis complex drug resistance pattern and identification of species causing tuberculosis in the West and Centre regions of Cameroon

Abstract

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.

Non-conversion of sputum culture among patients with smear positive pulmonary tuberculosis in Cameroon: a prospective cohort study

“…This prevalence is relatively high as compared to rates (0 to 2.7%) reported for patients with a first episode of SPPTB in the same region [14]. This suggests that patients with persistent culture positivity at the end of the 2 month intensive phase of anti-tuberculosis treatment constitute a high risk group for multidrug resistant tuberculosis MDR-TB.…”

Isolation, Identification and Determination of the Prevalence of &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt; Complex among People Living with HIV in Kisumu County, Kenya

“…The identification of the isolates by genotype MTBC revealed Mycobacterium tuberculosis as the only Mycobacterium specie causing pulmonary tuberculosis for the samples collected from Kisumu County. This bacterium has also been detected as the cause of tuberculosis in previous studies carried out in Uganda, Ethiopia and Cameroon [1,2,3]. Tuberculosis is caused by different species in the Mycobacterium tuberculosis complex family.…”

“…This agrees with study carried out in Cameroon. In the study, [2] reported that patients' age distribution showed a steady decline in age-specific prevalence from 30.58% in age group 15 -29 years to 15.51% in the age group above 60 years. Moreover, [10,11] documents that the youths had the highest TB notification.…”

HIV and Tuberculosis Trends in the United States and Select Sub-Saharan Africa Countries

“…Drug-resistant tuberculosis in Africa may be more prevalent than previously appreciated and is a serious problem for TB control programs in industrialized and developing countries alike [15]. In US, drug-resistant TB is relatively rare [16].…”