Abstract
Available molecular epidemiological data from recent studies suggest significant genetic variation between the different lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populations. This study sought to determine the population structure of clinical MTBC isolates from the Volta Region of Ghana. The MTBC isolates obtained from collected sputum samples were identified by PCR detecting of IS6110 and genotyped using spoligotyping. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplus. One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for MAF lineages. Spoligotyping identified 89 (76%) Lineage 4, 16 (13.6%) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.7%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two (2.2%) were orphan. Significant localization of MAF was found within the Ho municipality (n = 13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n = 3, 8.3%) (p-value = 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1). We confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.
Highlights
Tuberculosis (TB) still remains an important global public health problem and continues to pose great burden on the healthcare systems of many developing countries especially in SubSaharan Africa [1]
One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the M. tuberculosis complex (MTBC) of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%)
A total of 115 MTBC isolates were used for the downstream analysis
Summary
Tuberculosis (TB) still remains an important global public health problem and continues to pose great burden on the healthcare systems of many developing countries especially in SubSaharan Africa [1]. In Ghana, TB still poses a public health challenge with a TB incidence rate of 148/100,000 population per year, is ranked the 19th most TB-burdened country in Africa by WHO [1]. We know that these lineages exhibit a phylogeographical structure with specific lineages being associated with distinct geographical areas [4] suggesting potential host-pathogen interaction. This could influence the broad applicability of control tools such as diagnostics and vaccine [4]
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