Anti-tuberculosis drug resistance in the West Province of Cameroon

Int J Tuberc Lung Dis. 2000 Apr;4(4):356-60.

Abstract

Setting: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Cameroon / epidemiology
  • Drug Resistance, Microbial
  • Female
  • Hospitals, District
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycobacterium tuberculosis / classification*
  • Needs Assessment
  • Observation
  • Self Administration
  • Serotyping
  • Sputum / microbiology
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology*
  • Tuberculosis, Pulmonary / prevention & control

Substances

  • Antitubercular Agents