Epidemiology of tuberculosis in Cameroon as mirrored in notification data, 2006-2014.

SETTING: The Cameroonian National Tuberculosis Programme. OBJECTIVES: To assess case surveillance data for the 9-year period between January 2006 and December 2014. DESIGN: Retrospective descriptive analysis of tuberculosis (TB) case finding in Cameroon using routine surveillance data. Data on sociodemographic characteristics, disease category, clinical and laboratory variables, and geographic regions were analysed. RESULTS: The absolute number of TB cases (all forms) notified increased from 24 878 in 2006 to 26 517 in 2014; however, the population-adjusted annual case notification rate (CNR) of TB (all forms) as well as that of new smear-positive pulmonary TB cases decreased significantly, from 139 to 121 (P < 0.001) and from 77 to 70/100 000 population (P < 0.02), respectively. The human immunodeficiency virus (HIV) infection rate reported among all TB cases (39% in 2014) remained stable from 2009. The male-to-female ratio also remained stable, with a slight shift towards older age. There was a CNR gradient from the north to the south that appears to be related to HIV infection rates, population density and access to health services. CONCLUSIONS: TB CNRs in Cameroon for the 2006-2014 period show a slow but steady decrease, and there are indications that the trend reflects incidence. However, there is evidence to suggest that TB transmission is still ongoing.

High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon.

SETTING: Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon. OBJECTIVE: To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients. DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation. RESULTS: Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients. CONCLUSIONS: These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance.