title: Strong decrease in streptomycin-resistance and absence of XDR 12 years after the Reorganization of the National Tuberculosis Control Program in the Central Region of Cameroon.
abstract: BACKGROUND
  In the 1990s, resistance rates of 15% for streptomycin-resistance and 0.6% for multidrug-resistance (MDR) were reported from the Central Region of Cameroon. This work assesses drug resistant tuberculosis in this region 12 years after reorganization of the National Tuberculosis Control Program (NTCP).
  
  
  METHODS
  This cross-sectional study was conducted from April 2010 to March 2011 in Jamot Hospital in Yaoundé, Cameroon. Only patients with smear positive pulmonary tuberculosis were included. Sputa were cultured and subsequently underwent drug susceptibility testing (DST). All consenting individuals were tested for their HIV status.
  
  
  RESULTS
  A total of 665 smear positive pulmonary tuberculosis patients were enrolled. The HIV prevalence was 28.5% (95%CI [25.2-32.1]). Of the 582 sputa that grew Mycobacterium tuberculosis complex species, DST results were obtained for 576. The overall resistance rate was 10.9% (63/576). The overall resistance rates for single drug resistance were: isoniazid-resistance 4.7% (27/576), streptomycin-resistance 3.3% (19/576), rifampicin-resistance 0.2% (1/576), kanamycin-resistance 0.2% (1/576) and ofloxacin-resistance 0.2% (1/576). The MDR rate was 1.1% (6/576) and no extensively drug resistant tuberculosis (XDR) was detected.
  
  
  CONCLUSIONS
  The data show that reorganization of the NTCP resulted in a strong decrease in streptomycin-resistance and suggest that it prevented the emergence of XDR in the Central Region of Cameroon.
authors.affiliation: Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Larissa Kamgue
authors.initials: LK
authors.lastname: Sidze
authors.affiliation: Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mouafo Tekwu
authors.affiliation: Pneumology Unit, Jamot Hospital, Yaoundé, Cameroon.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kuaban
authors.affiliation: Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Assam Assam
authors.affiliation: Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tedom
authors.affiliation: Mycobacteriology Service, Reference laboratory of NTP, Centre Pasteur of Cameroon-Pasteur Institute International Network, Yaoundé, Cameroon.
authors.forename: Sara
authors.initials: S
authors.lastname: Eyangoh
authors.affiliation: Mbalmayo District Hospital, Mbalmayo, Cameroon.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Fouda
authors.affiliation: National Tuberculosis Control Program (NTCP), Yaoundé, Cameroon.
authors.forename: Désiré
authors.initials: D
authors.lastname: Nolna
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Université Marien Ngouabi, Brazzaville, Congo; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Francine
authors.initials: F
authors.lastname: Ntoumi
authors.affiliation: Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Deutsches Zentrum für Infektionsforschung (DZIF), Tübingen, Germany; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Matthias
authors.initials: M
authors.lastname: Frank
authors.affiliation: Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.
authors.forename: Véronique N
authors.initials: VN
authors.lastname: Penlap Beng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics; D009313:National Health Programs; D011159:Population Surveillance; D012307:Risk Factors; D012959:Socioeconomic Factors; D013307:Streptomycin / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D013307:Streptomycin