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Objectives To determine the prevalence and risk factors associated with rifampicin (RIF)‐resistant tuberculosis using GeneXpert technology. Methods A cross‐sectional study was conducted from April 2018 to November 2019 among tuberculosis (TB)‐infected Cameroonian patients in the Littoral Region using records from patients presenting with clinically suspected or documented TB. The patients were screened for TB using GeneXpert MDR/RIF ultra. Data were documented with an ad hoc survey form and analysed with SPSS version 22. Results 153 patients were included in the study. 64.1% were males; mean age was 37.9 ± 14.7 years and median age 37 years (range: 2–82). Most patients were new cases (76.4%). Relapses accounted for 8.5% and recurrences for 2.6%. Pulmonary TB was diagnosed among 98.7% patients using mostly sputum samples (85%). The prevalence of RIF resistance was 6.7% (95% CI: 3.4%–12.7%). This prevalence was significantly higher in samples of mucus and mucopurulent aspect (P‐value = 0.04). RIF‐resistant M. tuberculosis strains were significantly more frequent among relapses than new cases (23.1% vs. 2.3% P‐value < 0.0001). A statistically significant association was found between GeneXpert‐based quantification results and type and aspect of samples. Conclusion This study confirms the circulation of RIF‐resistant M. tuberculosis strains in the Littoral region. There is a need for extensive studies in other parts of the country.

Background There are growing reports on the prevalence of non-falciparum species and submicroscopic infections in sub-Saharan African countries but little information is available from Cameroon. Methods A hospital-based cross-sectional study was carried out in four towns (Douala, Maroua, Mayo-Oulo, and Pette) from three malaria epidemiological strata (Forest, Sahelian, and Soudanian) of Cameroon. Malaria parasites were detected by Giemsa light microscopy and polymerase chain reaction (PCR) assay. Non-falciparum isolates were characterized and their 18S gene sequences were BLASTed for confirmatory diagnosis. Results PCR assay detected malaria parasites in 82.4% (98/119) patients, among them 12.2% (12/98) were asymptomatic cases. Three Plasmodium species viz. P.falciparum, P.ovalecurtisi and P.vivax, and two co-infection types (P.falciparum + P.vivax and P.falciparum + P.ovalecurtisi) were found. The remaining infections were mono–infections with either P.falciparum or P.ovalecurtisi. All non–falciparum infections were symptomatic and microscopic. The overall proportion of submicroscopic infections was 11.8% (14/119). Most asymptomatic and submicroscopic infection cases were self-medicated with antimalarial drugs and/or medicinal plants. On analysis, P.ovalecurtisi sequences were found to be phylogenetically closer to sequences from India while P.vivax isolates appeared closer to those from Nigeria, India, and Cameroon. No G6PD-d case was found among non-falciparum infections. Conclusions This study confirms our previous work on circulation of P.vivax and P.ovalecurtisi and the absence of P.knowlesi in Cameroon. More studies are needed to address non-falciparum malaria along with submicroscopic infections for effective malaria management and control in Cameroon.

Background: There are growing reports on non-falciparum species and submicroscopic infections in sub-Saharan Africa countries but little information is available from Cameroon. Methods: A hospital-based cross-sectional study was carried out in four towns (Douala, Maroua, Mayo-Oulo and Pette) from three malaria epidemiological strata (Forest, Sahelian and Soudanian) of Cameroon. Malaria parasites were detected by Giemsa light microscopy and polymerase chain reaction (PCR). Non-falciparum samples were characterized and their 18S gene sequences were BLASTed. Results: Malaria parasites were PCR-detected in 82.4 % (98/119) of the patients and among them 12.2% (12/98) of asymptomatic cases. Three Plasmodium species viz. P. falciparum (Pf), P. ovale curtisi (PoC), and P. vivax (Pv), and two co-infection types (Pf + Pv and Pf + PoC) were found. The remaining infections were mono-infections with either Pf or PoC. All non-Pf infections were symptomatic and microscopic. The overall proportion of submicroscopic infections was 11.8% (14/119). Most of asymptomatic and submicroscopic infections cases were self-medicated with antimalarial drugs and/or medicinal plants. PoC sequences were phylogenetically closer to sequences from New Guinea, Benin and Guinea Bissau while Pv isolates appeared closer to those from China, Yemen and Iran. No G6PD-d case was found among the non-Pf infections. Conclusions: This study confirms our previous works on the circulation of Pv and PoC, and absence of P. knowlesi in Cameroon. More studies are needed to address non-falciparum malaria along with submicroscopic infections in context of antimalarial drug self-medication to efficiently manage and control malaria in Cameroon.