title: Mycobacterium tuberculosis complex drug resistance pattern and identification of species causing tuberculosis in the West and Centre regions of Cameroon.
abstract: BACKGROUND
  Data 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  M. 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.
authors.affiliation: Biotechnology Unit, Faculty of Science, University of Buea, P,O, Box 63 Buea, Cameroon.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Assam-Assam
authors.forename: Veronique B
authors.initials: VB
authors.lastname: Penlap
authors.forename: Fidelis
authors.initials: F
authors.lastname: Cho-Ngwa
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tedom
authors.forename: Irene
authors.initials: I
authors.lastname: Ane-Anyangwe
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Titanji
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000995:Antitubercular Agents / Q000494:pharmacology*; D002163:Cameroon; D024881:Drug Resistance, Bacterial; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D013045:Species Specificity; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents