Tuberculosis in Cameroon: The Fight Against the Silent Cough
The cough started as a small problem, a dry tickle that Amina, a final-year student at the University of Buea, thought was just from the cold weather. She was focused on her final year project, not the cough. Her friends told her it was just the “Buea cold,” something many people get.
But after six weeks, the cough got worse. It became a deep, heavy sound in her chest that left her out of breath when she performed her normal exercises. She started feeling tired all the time and her usual energy was gone. One evening, after a bad coughing fit, she saw a small spot of blood on her tissue. At that moment, she knew she could no longer ignore it. It was the start of a journey into the long and difficult fight against tuberculosis in Cameroon.
Understanding Tuberculosis in Cameroon
To understand Amina’s fear, we must look back at how serious TB was in Cameroon and across Africa. In the early 2000, the continent was fighting two major health problems at once: HIV and TB. The two diseases worked together in a destructive way. HIV weakens a person’s immune system, which is the body’s natural defense against illness. This makes it much easier for the person to get very sick from the TB bacteria. In Cameroon, the situation was critical. In 2003, the number of new TB cases reached a high of 321 for every 100,000 people. It was a major health crisis.
The tools used to diagnose TB back then were not very effective. The main laboratory method was to check a patient’s sputum (a mix of saliva and mucus) under a microscope. This technique was over 100 years old and often missed the TB bacteria, especially in patients who also had HIV. The only way to be certain was to grow the bacteria in a lab, which could take many weeks. During this long wait, a patient could get sicker and could also pass the disease on to others. It was a slow process in a fight where every day mattered.
A Modern Tool Changes the Fight
Then, a major change happened in the way TB was diagnosed. This change came from a modern machine called GeneXpert. For health workers who had only ever used microscopes, this new tool was a revolution.
The GeneXpert machine is a fast and accurate tool that checks for the bacteria’s genetic material. It works like a photocopier for DNA, taking a tiny amount from a patient’s sputum and making millions of copies until it is easy to see. The effect of this technology was huge. A patient in a small town, who before would have waited weeks for a result, could now get a clear answer in less than two hours.
The GeneXpert did something else just as important. In the same test, it could also check for signs that the TB was resistant to rifampicin, one of the most important TB drugs. This single test gave doctors two critical answers at once: Does the patient have TB? And is it already resistant to our main drug? This information allows doctors to start the right treatment immediately, which helps stop the spread of more dangerous forms of the disease.
The New Challenge: Drug-Resistant TB
While the new diagnostic tools brought hope, they also revealed the true size of a new challenge: multidrug-resistant tuberculosis (MDR-TB).
MDR-TB is a type of TB that does not get better with the main, most effective drugs. It develops when a patient does not finish their full treatment course. The few bacteria that survive can change (mutate) so the drugs no longer work on them. When these changed bacteria are passed to another person, the standard treatment will fail.
Treating MDR-TB is extremely difficult. Instead of taking a few pills for six months, a patient might need to take a complex mix of weaker, more toxic drugs for up to two years. The side effects can be very serious, including hearing loss and kidney problems. Recent data from Cameroon shows that 1.4% of new TB cases and 8.3% of previously treated cases are MDR-TB (Tchounga et al., 2024). This new form of TB has made the fight against the disease much more complicated.
The Path Forward: Working Together
To fight this complex disease, Cameroon’s Ministry of Public Health (MINSANTE) and its partners use several strategies. The most important strategy is called DOTS (Directly Observed Treatment, Short-course). In this system, a health worker watches the patient take their medicine every day. This simple step ensures patients complete their treatment and helps prevent the development of more drug-resistant TB.
Community health workers are the heroes of this effort. They travel to villages and towns to find people with TB, give them support during the long treatment and work to reduce the social stigma, or shame, that is often associated with the disease.
At the same time, top research centers like the Centre Pasteur du Cameroun in Yaoundé are using advanced science to help. They are studying the TB bacteria’s DNA to understand exactly how it spreads from person to person. This work is like detective work and can help stop outbreaks. The main goal of all TB research today is to find new drugs that can cure all forms of TB in a few months with fewer side effects.
Conclusion
Now, let’s go back to Amina.
At the clinic, she was terrified. But because of the progress Cameroon has made, her experience was different from what it would have been in the past. A nurse took her sample and, in less than two hours, the GeneXpert machine gave a clear result. The test was positive for TB, but it also showed that her illness was not resistant to the main drugs.
The fear she had felt for months was replaced with relief. Her illness was treatable. She was enrolled in the national TB program and started her six-month treatment with the support of a health worker. Her life was not over; it was just on hold.
Amina’s story is the story of Cameroon’s fight against TB. It is a story of past struggles and new hope from science and technology. The fight is not over. There are still many challenges, including finding all the missed cases and treating drug resistance. But with dedicated scientists, brave health workers and strong patients like Amina, the silent cough will not win.
References
Motta, I. et al. (2025) ‘Spatial analysis of notified tuberculosis cases and associated risk factors in Cameroon, 2019’, Scientific Reports, 15(1), p. 87682. Available at: https://www.nature.com/articles/s41598-025-87682-5.
Noeske, J. et al. (2016) ‘Tuberculosis case notification in Cameroon: trends over a decade (2006–2014) and effect of intensified case-finding measures’, The International Journal of Tuberculosis and Lung Disease, 20(8), pp. 1018–1024. Available at: https://pubmed.ncbi.nlm.nih.gov/27393535/.
Sander, M. S. et al. (2018) ‘High prevalence of tuberculosis among newly enrolled HIV patients in Bamenda, Cameroon: A cross-sectional study’, PLOS ONE, 13(6), p. e0199634. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199634.
Stop TB Partnership (2023) Cameroon TB country profile. Available at: https://tbassessment.stoptb.org/cameroon.html.
Tchounga, B. et al. (2024) ‘Epidemiology and treatment outcomes of drug-resistant tuberculosis in the Littoral region, Cameroon (2013–2022)’, BMC Public Health, 24(1), p. 20585. Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-20585-8.
World Bank (2022) Incidence of tuberculosis (per 100,000 people) – Cameroon. Available at: https://tradingeconomics.com/cameroon/incidence-of-tuberculosis-per-100-000-people-wb-data.html.
World Health Organization (2018) Global tuberculosis report 2018. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789241565646.
World Health Organization (2024a) WHO operational handbook on tuberculosis. Module 3: Diagnosis – Rapid diagnostics for tuberculosis detection. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240092785.
World Health Organization (2024b) Global tuberculosis programme data. Geneva: World Health Organization. Available at: https://www.who.int/teams/global-tuberculosis-programme/data .
I enjoyed the blog.