Rifampicin resistance in new bacteriologically confirmed pulmonary tuberculosis patients in Cameroon: A cross-sectional survey

Abstract

Objective: In Cameroon, tuberculosis (TB) cases are diagnosed and treated within a nationwide network of 248 diagnostic and treatment centres. In 2016, the centers notified a total of 175 multidrug-resistant (MDR-)TB cases, most of them retreatment cases. According to the WHO, the expected number of MDR-TB cases was estimated to be 1200 (1000-2200) corresponding to a rate of 6.8 (4.3-9.4) per 100,000 population. This indicates a notification gap of more than 80%. The objective of this study was to estimate the prevalence of MDR-TB in new bacteriologically confirmed pulmonary TB cases. We undertook a nationwide cross sectional survey during 6 weeks. Results: During the study period, the NTP notified 1478 new bacteriologically confirmed pulmonary TB cases. Among them, 1029 (70%) had a valid Xpert result and 16 were identified with rifampicin resistant (RR-TB), a tracer of MDR-TB. This gives a prevalence of 1.6% (95% CI 0.8-2.3) among incident cases. The rate of RR-TB in the regions varied between 0 and 3.3%. If the results of this study are confirmed, the incidence rate given by WHO (2.8%, 95% CI 2.1-3.4) might be an over-estimation.