Clinical characteristics and outcomes of tuberculosis in Douala, Cameroon: a 7-year retrospective cohort study.

SETTING: Tuberculosis (TB) clinic, Douala Laquintinie Hospital, Douala, Cameroon. OBJECTIVE: To describe the clinical characteristics of TB and to investigate predictors of poor treatment outcomes. DESIGN: A registry-based, retrospective cohort study of all TB cases recorded from 2007 to 2013 was conducted. Multinomial logistic regression models were used to identify predictors of poor outcomes. RESULTS: Of 8902 TB cases included, 5110 (57.4%) were males. The median age was 33 years. The prevalence of human immunodeficiency virus (HIV) infection was 37.6%, with a significant decline over the study years (P = 0.000). The main clinical form of TB was smear-positive TB (50.5%). The treatment success rate was 75.2%, while the mortality rate was 8.1%. The year of TB diagnosis, retreatment cases, sputum non-conversion at the end of month 2, HIV infection and HIV testing not done were associated with death. Retreatment and non-conversion of sputum were associated with treatment failure, while male sex, age, sputum non-conversion, HIV infection and HIV testing not done were associated with loss to follow-up. CONCLUSION: TB management objectives may be attained by focusing specifically on higher risk groups to prevent poor treatment outcomes.

Non-Infectious Lung Manifestations of Autoimmune Diseases in Cameroon

Autoimmune (AI) diseases are secondary to lack of tolerance against self antigens. They may have systemic or organ-specific manifestations. All lung structures can be affected. The aim of our study was to determinate clues of diagnosis and treatment facilities for noninfectious lung manifestations of AI disease.A multi-centre retrospective study was performed from January 2006 to July 2009 in Douala, Cameroon.Twenty-nine patients were included (59% female),with an average age of 42±10 (18­58) years. The lung was the discovery mode of AI disease in 79%. Systemic lupus erythematosus (SLE) was the most frequently observed AI disease (48%). Thirty-eight percent have at least one cure against pleural or smear-negative tuberculosis. Clinical anomalies found were: cough 79%, dyspnoea 69%, and crackles 41%. Morphological anomalies were interstitial lesions in 55% of chest Xrays,50% of ground grass pattern, and 25% of fibrosis on CT scan; chest function test showed restrictive pattern in 41%. Three (10%) patients were HIV positive with a CD4 cell count more than 500/mm³. Two patients underwent talc pleurodesis for recurrent pleural effusion. General steroids were prescribed to all patients, hydroxychloroquine to 31% and azathioprine to 21%. At the time of writing, 18 patients were still being followed up and 3 (10%) had died. AIs exist in many countries. Clues of diagnosis of non-infectious pulmonary involvement are a patient presenting with chronic respiratory symptoms, crackles at physical examination, negative sputum smear,and unusual chest X-ray abnormality for tuberculosis