Abstract
The tuberculosis (TB) incidence rate in Brussels-Capital Region is 3-fold higher than in Belgium as a whole. Eight years after the realization of initial prospective population-based molecular epidemiology investigations in this Region, a similar study over the period 2010–2013 was conducted. TB strains isolated from 945 patients were submitted to genotyping by standardized 24-locus-MIRU-VNTR typing and spoligotyping. The phylogenetic analysis showed that the LAM (16.7%) and Haarlem (15.7%) branches are the two most prevalent TB lineages circulating in Brussels. Analysis of the MDR subgroup showed an association with Beijing strains (39.9%) and patients native of Eastern Europe (40.7%). Genotyping detected 113 clusters involving 321 patients, giving a recent transmission index of 22.9%. Molecular-guided epidemiological investigations and routine surveillance activities revealed family transmission or social contact for patients distributed over 34 clusters. Most of the patients were foreign-born (75.7%). However, cluster analysis revealed only limited trans-national transmission. Comparison with the previous study shows a stable epidemiological situation except for the mean age difference between Belgian-born and foreign-born patients which has disappeared. This study confirms that molecular epidemiology has become an important determinant for TB control programs. However, sufficient financial means need to be available to perform all required epidemiological investigations.
Highlights
Tuberculosis (TB) remains a major public health concern, even in developed countries
Genetic lineages of the strains were determined by comparison of the obtained spoligotypes with those recorded at the www.miru-vntrplus.org [17,18]
This report presents the conclusion of a population-based molecular epidemiology study conducted over the period 2010–2013 on 945 positive cultures TB patients living in Brussels-Capital Region
Summary
Tuberculosis (TB) remains a major public health concern, even in developed countries. According to the World Health Organisation (WHO), an estimated 10.4 million people developed TB in 2015 and 1.4 million died from the disease [1]. In Belgium, the incidence in 2015 was 8.8 cases per 100,000 inhabitants, explaining its status of low TB incidence country. TB incidence rate in Brussels-Capital Region (25.9/100,000) is almost 3-fold higher than for the whole country while more than two thirds of the patients are foreign-born [2]. Immigration from Eastern and Central Europe was increasing [3]
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