Jouego Christelle Geneviève, Collins Titahong Nosoh, Tegomoh Bryan, Geenen Caspar, Netongo Palmer Masumbe, André Emmanuel, Faccin Mauro
Molecular Diagnostics Research Group (MDRG), University of Yaoundé 1, Yaoundé, Cameroon.
Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Sci Rep. 2025 Feb 10;15(1):4992. doi: 10.1038/s41598-025-87682-5.
Since 2012, Cameroon has introduced rapid molecular diagnostic tests for tuberculosis (TB). Despite this progress, WHO estimates indicate a TB diagnostic gap of 43% at the national level in 2019. This raises questions about the strategic allocation of available rapid molecular diagnostic tools to areas with lower TB notification. In a cross-sectional study, we combined Cameroon notification data on TB (2019), rifampicin-resistant (RR)-TB (2015-2019), as well as local TB risk factors, availability, intensity of use and accessibility of the Xpert MTB-RIF test with openly available geospatial datasets from OpenStreetMap and WorldPop. A mathematical model estimated TB and RR-TB incidence rates at the regional level. We compared these estimates with the number of reported TB cases to identify diagnostic gaps. Centre, East and Far North regions had the highest estimated TB incidence rates (400, 300 and 200 cases per 100,000 inhabitants, respectively), while South and Adamawa had the highest estimated RR-TB incidence rates (14.9 and 8.9 cases per 100,000 inhabitants, respectively). We report a national diagnostic gap of 53% and 50% for TB and RR-TB, respectively. These findings highlight the need to improve the allocation of diagnostic tools that follows the local disease burden in resource-limited settings to improve health equity.
自2012年以来，喀麦隆已引入结核病快速分子诊断检测。尽管取得了这一进展，但世界卫生组织的估计表明，2019年全国结核病诊断缺口为43%。这引发了关于将现有的快速分子诊断工具战略分配到结核病通报率较低地区的问题。在一项横断面研究中，我们将喀麦隆的结核病（2019年）、耐利福平结核病（RR-TB，2015 - 2019年）通报数据，以及当地结核病风险因素、Xpert MTB-RIF检测的可用性、使用强度和可及性，与来自OpenStreetMap和WorldPop的公开地理空间数据集相结合。一个数学模型估计了区域层面的结核病和RR-TB发病率。我们将这些估计值与报告的结核病病例数进行比较，以确定诊断缺口。中部、东部和远北地区的估计结核病发病率最高（分别为每10万居民400例、300例和200例），而南部和阿达马瓦地区的估计RR-TB发病率最高（分别为每10万居民14.9例和8.9例）。我们报告全国结核病和RR-TB的诊断缺口分别为53%和50%。这些发现凸显了在资源有限的环境中，需要根据当地疾病负担改进诊断工具的分配，以促进健康公平。
