Abstract

BackgroundThe population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown.MethodsA comparative cross sectional study was conducted on 126 MTBC strains isolated from prisons and communities in southwestern, southern and eastern Ethiopia. Phenotypic drug susceptibility testing was performed with the MGIT960 system. Combined 24-loci Mycobacterium interspersed repetitive unit-variable number tandem repeat and spacer oligonucleotide typing methods were used to study the MTBC population structure. The obtained data from prisons and communities were compared using statistical tests and regression analysis.ResultsA diverse population structure with 11 different lineages and sub-lineages was identified. The predominant strains were the recently described Ethiopia_H37Rv like (27.52%) and Ethiopia_3 (16.51%) with equal lineage distribution between prisons and communities. 28.57% of prison strains and 31.82% of community strains shared the identical genotype with at least one other strain. The multidrug-resistance (MDR) prevalence of the community was 2.27% whereas that of prisons was 9.52%. The highest mono resistance was seen against streptomycin (15.89%).ConclusionTuberculosis in communities and prisons is caused by a variety of MTBC lineages with predominance of local Ethiopian lineages. The increasing prevalence of MDR MTBC strains is alarming. These findings suggest the need for new approaches for control of MDR tuberculosis in Ethiopia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2041-x) contains supplementary material, which is available to authorized users.

Highlights

  • The population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown

  • Our study provides first data on MTBC population structure and drug resistance pattern of strains found in Ethiopian prisons and in regional states of the country which were not studied before

  • Our findings suggest that TB is still not sufficiently controlled in specific, potentially remote, areas of the country and highlight the need for improved tools and new strategies aiming for MDRTB control, especially in prisons

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Summary

Introduction

The population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown. Despite recent achievements seen in the fight against tuberculosis (TB), it still remains a significant cause of morbidity and mortality in Ethiopia [1] This situation is worsened by an increase in prevalence of multidrugresistant (MDR) Mycobacterium tuberculosis complex (MTBC) strains, defined as resistance to at least the two most powerful first line anti-tuberculosis drugs; isoniazid (INH) and rifampicin (RIF) [2]. TB incidence and MDR rates in prisons have been found to be higher compared to that reported in the general population in several studies [5,6,7].

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