Anti-tuberculosis drug resistance in the West Province of Cameroon.
METHODS
All 15 district hospitals of the West Province of Cameroon, between July 1997 and June 1998.


OBJECTIVE
To determine the prevalences of initial and acquired resistance to the main anti-tuberculosis drugs 2 years after the implantation of a tuberculosis control programme in the province.


METHODS
A total of 615 adults consecutively admitted to the 15 district hospitals with sputum smear-positive pulmonary tuberculosis were systematically studied. Sputum specimens collected from each patient were cultured on Lowenstein-Jensen medium. Testing of susceptibility to the major anti-tuberculosis drugs was performed by the indirect proportion method.


RESULTS
Growth of Mycobacterium tuberculosis complex strains was obtained from specimens of 566 (92%) of the 615 patients. The overall resistance rate (one or more drugs) was 26.9%, with initial resistance being 19.7% (86/437) and acquired resistance 51.1% (66/129). Initial resistance to isoniazid was the most common (12.1%), followed by streptomycin (11.7%), ethambutol (2.5%) and rifampicin (2.1%). Initial resistance was noted as 13.5% to one drug, 4.3% to two, 1.1% to three and 0.7% to four. Acquired resistance to isoniazid was the most frequent (41.1%), followed by streptomycin (26.4%), rifampicin (14.7%) and ethambutol (9.3%). Acquired resistance was 25.6% to one drug, 14.7% to two, 7% to three and 3.9% to four.


CONCLUSIONS
The proportion of resistant tuberculosis in the West Province is quite high. This underscores the need for the improvement of the control programme by introducing the DOTS strategy.
Kuaban
C
C
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Cameroon. c.pasteur@camnet.cm
Bercion
R
R
Noeske
J
J
Cunin
P
P
Nkamsse
P
P
Ngo Niobe
S
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002163:Cameroon / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D005260:Female; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification*; D020380:Needs Assessment; D019370:Observation; D012646:Self Administration; D012703:Serotyping; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control
D000995:Antitubercular Agents