Abstract
Worldwide, studies investigating the relationship between the lineage of Mycobacterium tuberculosis (MTB) across geographic areas has empowered the “End TB” program and understand transmission across national boundaries. Genomic diversity of MTB varies with geographical locations and ethnicity. Genomic diversity can also affect the emergence of drug resistance. In Myanmar, we still have limited genetic information about geographical, ethnicity, and drug resistance linkage to MTB genetic information. This study aimed to describe the geno-spatial distribution of MTB and drug resistance profiles in Myanmar–Thailand border areas. A cross-sectional study was conducted with a total of 109 sequenced isolates. The lineages of MTB and the potential associated socio-demographic, geographic and clinical factors were analyzed using Fisher’s exact tests. p value of statistically significance was set at < 0.05. We found that 67% of the isolates were lineage 1 (L1)/East-African-Indian (EAI) (n = 73), followed by lineage 2 (L2)/Beijing (n = 26), lineage 4 (L4)/European American (n = 6) and lineage 3 (L3)/Delhi/Central Asian (n = 4). “Gender”, “type of TB patient”, “sputum smear grading” and “streptomycin resistance” were significantly different with the lineages of MTB. Sublineages of L1, which had never been reported elsewhere in Myanmar, were detected in this study area. Moreover, both ethnicity and lineage of MTB significantly differed in distribution by patient location. Diversity of the lineage of MTB and detection of new sublineages suggested that this small area had been resided by a heterogeneous population group who actively transmitted the disease. This information on distribution of lineage of MTB can be linked in the future with those on the other side of the border to evaluate cross-border transmission.
Highlights
Myanmar and Thailand, two bordering countries, are among the top 30 high burden countries for tuberculosis (TB) [1]
There was no significant association between major lineages of Mycobacterium tuberculosis (MTB) and township, age of the patients, and ethnicity
The Mycobacterium tuberculosis population in the study area was genetically diverse with the total of 4 lineages and at least 30 sublineages identified among 109 study isolates
Summary
Myanmar and Thailand, two bordering countries, are among the top 30 high burden countries for tuberculosis (TB) [1]. Border health is still one of the challenges in TB response especially in limited resources country such as Myanmar because of its low socio-economic level, minority ethnic groups, and migrant issues [2]. The generally used molecular genotyping methods for Mycobacterium tuberculosis (MTB) give limited discrimination power because only a small part of the genome was examined. Transmissibility, host response, and the emergence of drug resistance [6,7,8]. This information on distribution of lineage of MTB across geographic areas has empowered the global TB response
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