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Molecular epidemiology of Mycobacterium africanum in Ghana.

Molecular epidemiology of Mycobacterium africanum in Ghana.
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Asante-Poku A, Otchere ID, Osei-Wusu S, Sarpong E, Baddoo A, Forson A, Laryea C, Borrell S, Bonsu F, Hattendorf J, Ahorlu C, Koram KA, Gagneux S, Yeboah-Manu D,


Asante-Poku A, Otchere ID, Osei-Wusu S, Sarpong E, Baddoo A, Forson A, Laryea C, Borrell S, Bonsu F, Hattendorf J, Ahorlu C, Koram KA, Gagneux S, Yeboah-Manu D, (click to view)

Asante-Poku A, Otchere ID, Osei-Wusu S, Sarpong E, Baddoo A, Forson A, Laryea C, Borrell S, Bonsu F, Hattendorf J, Ahorlu C, Koram KA, Gagneux S, Yeboah-Manu D,

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BMC infectious diseases 2016 08 0916() 385 doi 10.1186/s12879-016-1725-6

Abstract
BACKGROUND
Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana.

METHOD
We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression.

RESULTS
Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05-0.77, P < 0.01). Multivariate analysis showed that Lineage 5 was significantly more common in patients from the Ewe ethnic group (adjusted odds ratio (adjOR): 2.79; 95 % CI: 1.47-5.29, P < 0.001) and Lineage 6 more likely to be found among HIV-co-infected TB patients (adjOR = 2.2; 95 % confidence interval (CI: 1.32-3.7, P < 0.001). CONCLUSION
Our findings confirm the importance of M. africanum in Ghana and highlight the need to differentiate between Lineage 5 and Lineage 6, as these lineages differ in associated patient variables.

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