Human immunodeficiency virus and tuberculosis coinfection prevalence and treatment outcomes in Cameroon: a systematic review and meta-analysis
- 1Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon
Abstract
Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) form one of the deadliest syndemics, and sub-Saharan Africa bears over 80% of HIV-associated TB deaths. In Cameroon, evidence on HIV/TB coinfection remains unsynthesized across regions and populations, obscuring the national burden. Hence, we estimated the prevalence of HIV/TB coinfection and treatment outcomes in Cameroon. Methods: Following PRISMA 2020 (PROSPERO: CRD420261399169), we searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, African Journals Online, and grey literature for English- and French-language studies conducted in Cameroon. Reports were independently screened, their data extracted, and their methodology appraised using Joanna Briggs Institute tools. Random-effects models pooled prevalence, treatment outcomes, and adjusted odds ratios. Heterogeneity was assessed with I2. Results: Seventy studies (1995-2023) were included, 87.1% at low risk of bias. Pooled HIV prevalence among TB patients was 29.2% (95% CI: 26.3-32.3; 67 studies; n=57,169; I2 = 97.8%), with no significant evidence of publication bias. Prevalence was higher from 2007 onwards (29.9%; 62 studies; n=55,358) than before (20.5%; 5 studies; n=1,811). It was highest in the North-West (41.9%; 7 studies; n=6,324) versus Littoral (25.0%; 15 studies; n=10,419) and West (23.8%; 6 studies; n=4,206); and in extrapulmonary TB (42.3%; 3 studies; n=371) versus mixed forms (37.7%; 21 studies; n=37,239) and pulmonary TB (23.9%; 37 studies; n=16,096) (all p<0.05). Among coinfected patients, pooled treatment success was 75.9% (95% CI: 70.4-80.8; 8 studies; n=4,230), mortality 21.1% (95% CI: 11.9-34.7; 10 studies; n=4,403), loss to follow-up 7.7% (95% CI: 4.3-13.3; 5 studies; n=3,103), and treatment failure 0.3% (95% CI: 0.1-1.5; 6 studies; n=3,520). Lack of antiretroviral therapy (ART) increased the odds of unfavorable outcomes (AOR = 1.90; 95% CI: 1.15-3.12; 2 studies). Conclusions: Approximately three in ten TB patients in Cameroon are coinfected with HIV, with marked regional and clinical variation. Treatment success remains below national targets. Strengthening TB-HIV service integration, routine HIV testing, and timely ART initiation and continuation is essential to reduce the HIV-associated TB morbidity and mortality in the country.
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BibTeX
@misc{cheuyem2026human,
title = {{Human immunodeficiency virus and tuberculosis coinfection prevalence and treatment outcomes in Cameroon: a systematic review and meta-analysis}},
author = {F. Z. L. Cheuyem and R. Tchamani and A. D. Touko and C. Achangwa and C. J. K. Mapouo and G. C. M. Fouodjeu and A. Nouko and S. Modibo},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.07.26367493},
url = {https://www.medrxiv.org/content/10.64898/2026.11.07.26367493v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Human immunodeficiency virus and tuberculosis coinfection prevalence and treatment outcomes in Cameroon: a systematic review and meta-analysis
AU - F. Z. L. Cheuyem
AU - R. Tchamani
AU - A. D. Touko
AU - C. Achangwa
AU - C. J. K. Mapouo
AU - G. C. M. Fouodjeu
AU - A. Nouko
AU - S. Modibo
PY - 2026
DA - 2026/11/07
PB - medRxiv
DO - 10.64898/2026.11.07.26367493
UR - https://www.medrxiv.org/content/10.64898/2026.11.07.26367493v1
AB - Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) form one of the deadliest syndemics, and sub-Saharan Africa bears over 80% of HIV-associated TB deaths. In Cameroon, evidence on HIV/TB coinfection remains unsynthesized across regions and populations, obscuring the national burden. Hence, we estimated the prevalence of HIV/TB coinfection and treatment outcomes in Cameroon. Methods: Following PRISMA 2020 (PROSPERO: CRD420261399169), we searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, African Journals Online, and grey literature for English- and French-language studies conducted in Cameroon. Reports were independently screened, their data extracted, and their methodology appraised using Joanna Briggs Institute tools. Random-effects models pooled prevalence, treatment outcomes, and adjusted odds ratios. Heterogeneity was assessed with I2. Results: Seventy studies (1995-2023) were included, 87.1% at low risk of bias. Pooled HIV prevalence among TB patients was 29.2% (95% CI: 26.3-32.3; 67 studies; n=57,169; I2 = 97.8%), with no significant evidence of publication bias. Prevalence was higher from 2007 onwards (29.9%; 62 studies; n=55,358) than before (20.5%; 5 studies; n=1,811). It was highest in the North-West (41.9%; 7 studies; n=6,324) versus Littoral (25.0%; 15 studies; n=10,419) and West (23.8%; 6 studies; n=4,206); and in extrapulmonary TB (42.3%; 3 studies; n=371) versus mixed forms (37.7%; 21 studies; n=37,239) and pulmonary TB (23.9%; 37 studies; n=16,096) (all p<0.05). Among coinfected patients, pooled treatment success was 75.9% (95% CI: 70.4-80.8; 8 studies; n=4,230), mortality 21.1% (95% CI: 11.9-34.7; 10 studies; n=4,403), loss to follow-up 7.7% (95% CI: 4.3-13.3; 5 studies; n=3,103), and treatment failure 0.3% (95% CI: 0.1-1.5; 6 studies; n=3,520). Lack of antiretroviral therapy (ART) increased the odds of unfavorable outcomes (AOR = 1.90; 95% CI: 1.15-3.12; 2 studies). Conclusions: Approximately three in ten TB patients in Cameroon are coinfected with HIV, with marked regional and clinical variation. Treatment success remains below national targets. Strengthening TB-HIV service integration, routine HIV testing, and timely ART initiation and continuation is essential to reduce the HIV-associated TB morbidity and mortality in the country.
ER -