Abstract
Tuberculosis incidence among aborigines is significantly higher than for Han Chinese in Taiwan, but the extent to which Mycobacterium tuberculosis (MTB) strain characteristics contribute to this difference is not well understood. MTB isolates from aborigines and Han Chinese living in eastern and southern Taiwan, the major regions of aborigines, were analyzed by spoligotyping and 24-loci MIRU-VNTR. In eastern Taiwan, 60% of aboriginal patients were ≤20 years old, significantly younger than the non-aboriginal patients there; aborigines were more likely to have clustered MTB isolates than Han Chinese (odds ratio (OR) = 5.98, p<0.0001). MTB lineages with high clustering were EAI (54.9%) among southern people, and Beijing (62.5%) and Haarlem (52.9%) among eastern aborigines. Resistance to first-line drugs and multidrug resistance (MDR) were significantly higher among eastern aborigines (≥15%) than in any other geographic and ethnic group (p<0.05); MDR was detected in 5 of 28 eastern aboriginal patients ≤20 years old. Among patients from the eastern region, clustered strains (p = 0.01) and aboriginal ethnicity (p = 0.04) were independent risk factors for MDR. The lifestyles of aborigines in eastern Taiwan may explain why the percentage of infected aborigines is much higher than for their Han Chinese counterparts. The significantly higher percentage of the MDR-MTB strains in the aboriginal population warrants close attention to control policy and vaccination strategy.
Highlights
Tuberculosis (TB) remains a global threat to public health and is considered by the World Health Organization (WHO) to be an epidemic [1]
To better understand the reasons for the high TB rates among aborigines, we investigated the genetics of Mycobacterium tuberculosis (MTB) strains infecting aboriginal and Han Chinese TB patients in eastern Taiwan, and used TB patients from southern Taiwan as the comparison group
Characteristics of TB patients At Tzu-Chi General Hospital (TCGH), 148 MTB isolates from 47 aboriginal patients (31.76%) and 101 non-aboriginal patients (Han Chinese) (68.24%) were subjected to spoligotyping and MIRU-VNTR typing
Summary
Tuberculosis (TB) remains a global threat to public health and is considered by the World Health Organization (WHO) to be an epidemic [1] It is still the leading cause of death for notifiable infectious diseases in Taiwan despite a steady decrease in both TB incidence and mortality rates since 1950. Aboriginal populations experience a 4- to 6-fold higher incidence and prevalence of TB compared to non-aboriginal populations [2] The reasons for this are not fully understood, but could include a variety of factors such as predisposing genetic polymorphisms of the human SLC11A1 (NRAMP-1) gene [3] and the particular Mycobacterium tuberculosis (MTB) strains circulating in the respective populations, as well as societal issues. To better understand the reasons for the high TB rates among aborigines, we investigated the genetics of MTB strains infecting aboriginal and Han Chinese TB patients in eastern Taiwan, and used TB patients from southern Taiwan as the comparison group
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
