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.

Spatial analysis of tuberculosis in Douala, Cameroon: clustering and links with socio-economic status.

SETTING: Douala, the economic capital of Cameroon, with a network of 20 diagnostic and treatment centres for tuberculosis (TB). OBJECTIVE: To describe the spatial distribution of smear-positive pulmonary tuberculosis (PTB) cases in Douala, Cameroon, and to evaluate links between PTB incidence and patients' socio-economic status (SES). DESIGN: Between May 2011 and April 2012, demographic clinical characteristics and global positioning system coordinates for the residence of each consenting PTB case were collected. Spatial scan statistic was used to identify spatial clusters of tuberculosis. SES data were collected by interview during home visits. PTB patients' SES data were compared with those available for the whole urban population from a recent demographic and health survey. The correlation between PTB incidence and the mean SES of the PTB patients was examined by health area (HA). RESULTS: In total, 2132 (84%) diagnosed PTB cases were identified and interviewed. Three statistically significant spatial clusters were identified. High PTB incidence was predominantly found in HAs characterised by low SES. CONCLUSION: There is evidence of clustering of PTB cases in Douala. Clusters are mainly found in neighbourhoods of low SES. Systematic use of cluster detection techniques for regular TB surveillance in Cameroon might aid in the effective deployment of National TB Programme resources.