Setting: Tuberculosis centre in Hopital Jamot, Yaounde, the sole referral facility for tuberculosis treatment
Objectives: To identify strains of M tuberculosis responsible for pulmonary tuberculosis and to determine the prevalence of initial resistance to the main drugs used for treatment and to compare this prevalence between those HIV positive and HIV negative
Design: 576 consecutive, previously untreated, adult patients with smear positive pulmonary tuberculosis, admitted between July 1994 and December 1995 were studied. Standard species identification was carried out. Sputum was cultured on Lowenstein-Jensen and Coletsos media. Susceptibility of isolates to major drugs was tested using the indirect proportion method. HIV testing was performed with 2 ELISAs and confirmed with Western Blot.
Results: M. tuberculosis was isolated in 516 (90%) of the cases. Of the 516 cases, 92 (18%) were HIV positive. Of the 516 strains isolated, 164 (32%) were resistant to at least one drug. Resistance was noted as follows: 25% to one drug, 5.8% to 2 drugs, and 1% to three or more. Initial resistance was most frequent to Streptomycin (20.5%), followed by isoniazid (12.4%), rifampicin (0.8%) and ethambutol (0.4%). No significant difference was observed between HIV-positive and HIV-negative patients.
Conclusion: Initial drug resistance to M tuberculosis is relatively high in Yaounde.
