Current Status of Human Tuberculosis in Cameroon

Human tuberculosis (TB) is highly prevalent in Cameroon, and it has a current annual incidence of over 200 cases per 100,000 population (WHO 2009) (Table 12.5). The unfavorable local socioeconomic conditions, the close association of TB with the HIV epidemic, and the widespread mycobacterial resistance to drugs used in the treatment of TB hamper its control (Kuaban et al.

2000a). Because of the close association between the re-emergence of TB and the emerging HIV/AIDS epidemic in Cameroon (WHO 2009) (Table 12.5), the seroprevalence of HIV in TB patients serves as an accurate indicator of the prevalence of HIV in the general population (Noeske et al. 2004). In addition to HIV/AIDS, other factors such as poverty, malnutrition, stress, and smoking are important risk factors predisposing to contracting the disease (Pesut et al. 2008).

Table 12.4 Degree of interaction of cattle handlers with their cattle and their knowledge of zoonotic BTB and its modes of transmission (values are in percentages)

Variable	Proportion of respondents (ιι = 489)		Contact between cattle handlers and animals (n = 489: ADP = 302, WHC = 187)		Know BTB is zoonotic (n = 477)	Mode of transmission of BTB to humans (ιι = 477: ADP = 298, WHC = 179)
Variable		Own other livestock spp.	Daily contact with cattle herds	≥ 1-day contact with cattle herds per week	Know BTB is zoonotic (n = 477)	Knows milk is a vehicle	Knows raw meat is a vehicle	Knows inhalation route (aerosol)

Highland region

ADP	61.8	8.3a	87.8a	12.3a	51.7a	14.4a	43.6a	11.4a
WHC	38.2	73.8b	86.1a	13.9a	62.0b	14.0a	46.4a	19.5b
Total	100	33.3	87.1	12.9	55.6	14.3	44.7	14.5

Occupation

Cattle breeder	57.7	35.5c	83.7b	16.3bd	53.1 cd	19.3b	43.6bc	16.4c
Butcher	22.5	28.2d	97.3c	2.7c	63.0c	7.4c	55.6b	12.0d
"Buyem sellem^,'	7.6	64.9e	75.7b	24.3b	67.6c	5.9c	35.3c	8.8d
Herdsmen	12.3	13.3d	91.7c	13.3d	46.7d	8.3c	36.7c	13.3d

ii = total number of respondents, ADP Adamawa Plateau, WHC Western Highlands, a-к: different letters in the same column are significantly different (P < 0.05) (Awah-Ndukum et al. unpublished data; Awah-Ndukum et al.

2014)

Table 12.5 Estimated burden of human TB in Cameroon, 2000-2007

bgcolor=white>15

Parameter	2000	2001	2002	2003	2004	2005	2006	2007
Incidence^a rates of TB (per 100,000 population)	168	181	194	202	204	202	197	192
Prevalence^a rates of TB (per 100,000 population)	228	241	240	227	228	2103	201	195
Incidence rates of TB/HIV- positive number (per 100,000 population)	77	83	88	91	91	89	86	83
Prevalence rates of TB/HIV- positive number (per 100,000 population)				20	20	16	41
Prevalence of HIV in incident TB cases of all ages^b (%)				-	31	26	15	43

^aIncidence and prevalence estimates include TB in people with HIV

^bPrevalence of HIV in incident TB cases of all ages [adapted from Global TB control, surveillance, planning, and financing (WHO 2009)]

The prevalence of human TB in Cameroon is still increasing, especially in the economically active age group (21-40 years) and in immunocompromised individuals, such as those suffering from HIV/AIDS (WHO 2009; Noeske et al.

2004; Ane-Anyangwe et al. 2006). About 40% of all TB patients in the country are also HIV-positive, and the prevalence of HIV both in the general adult population and in adults with TB is steadily increasing. More recent studies of HIV/AIDS in TB cases of all ages in the general population indicated an even higher prevalence (ranging from 31 to 43%) (WHO 2009). Due to the magnitude and the increase of the two infections in Cameroon, it is expected that even after the HIV epidemic in the general population reached its peak and starts to decline, TB/HIV coinfection would probably continue to occur since TB can be contracted at any time during the course of an HIV infection (Noeske et al. 2004).

12.6

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Source: Dibaba A.B., Kriek N.P.J., Thoen C.O. (eds.). Tuberculosis in Animals: An African Perspective. Springer,2019. — 453 p.. 2019

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