Tuberculosis Unit
Infectious diseases represent a public health challenge especially in resource-limited countries. Tuberculosis (TB) is caused in humans by a bacterial pathogen belonging to genus Mycobacterium with M. tuberculosis as the main species involved in human cases and deaths. In 2018, TB was responsible for 10 million disease cases, 1.2 million deaths among HIV-negative, and 251,000 deaths among HIV-positive people, mainly in adults aged ≥15 years. In Cameroon, TB is also a cause of concern with an incidence and a mortality rate of 194 and 30 for 100,000 people, respectively, with a predominance among females.
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. 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 . However, tuberculosis still remains one of the public health priorities alongside malaria and HIV in Cameroon especially in the Littoral Region. People living in this region are highly at risk of suffering and dying from TB. This is supported by the fact that the Littoral Region is ranked third among the 10 regions of the country in terms of notification rates of new bacteriologically confirmed pulmonary tuberculosis. In addition, HIV infection is also prevalent in the Littoral Region and complicates management of TB-infected patients like in most sub-Saharan Africa (SSA) countries. As a consequence, death rates in coinfected HIV/TB patients from SSA countries have risen over the last few decades.
We present in this study an overview of treatment outcomes of TB in Cameroon for the period 2014–2016 using a more robust analysis method based on meta-analysis approach. In addition, we evaluate the influence of loss to follow-up and death rates and the cotrimoxazole (CTX) and antiretroviral therapy (ART) coverage in treatment outcomes of the TB therapy by performing subgroup analysis. It is hoped that this overview will improve the understanding of the dynamics of TB treatment in Cameroon and inform policy.