乌干达坎帕拉城郊儿童中结核分枝杆菌复合群谱系的分布与传播

Distribution and transmission of Mycobacterium tuberculosis complex lineages among children in peri-urban Kampala, Uganda.

作者信息

Wampande Eddie M, Mupere Ezekiel, Jaganath Devan, Nsereko Mary, Mayanja Harriet K, Eisenach Kathleen, Boom W Henry, Gagneux Sebastien, Joloba Moses L

机构信息

Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda.

Department of Bio-molecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Bio Security, Makerere University, Kampala, Uganda.

出版信息

BMC Pediatr. 2015 Sep 30;15:140. doi: 10.1186/s12887-015-0455-z.

DOI:10.1186/s12887-015-0455-z

PMID:26424324

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4588907/

Abstract

BACKGROUND

To gain insight into the transmission of tuberculosis (TB) in peri-urban Kampala-Uganda, we performed a household contact study using children as a surrogate for recent transmission of Mycobacterium tuberculosis (MTB). Using this approach, we sought to understand M. tuberculosis complex (MTBC) lineage diversity, distribution and how these relate to TB transmission to exposed children.

METHOD

MTBC isolates from children aged ≤ 15 years, collected from 2002 to 2010 in a household-contact study, were analyzed using a LightCycler RT-PCR SNP genotyping assay (LRPS). The resultant genotypic data was used to determine associations between MTBC lineage and the children's clinical and epidemiological characteristics.

RESULTS AND DISCUSSION

Of the 761 children surveyed, 9% (69/761) had culture-positive TB an estimate in the range of global childhood TB; of these 71% (49/69) were infected with an MTBC strain of the "Uganda family", 17% (12/69) infected with MTBC lineage 4 strains other than MTBC Uganda family and 12% (8/69) infected with MTBC lineage 3, thereby disproportionately causing TB in the study area. Overall the data showed no correlation between the MTBC lineages studied and transmission (OR = 0.304; P-value = 0.251; CI: 95%; 0.039-2.326) using children a proxy for TB transmission.

CONCLUSIONS

Our findings indicate that MTBC Uganda family strains are the main cause of TB in children in peri-urban Kampala. Furthermore, MTBC lineages did not differ in their transmissibility to children.

摘要

背景

为深入了解乌干达坎帕拉城郊地区结核病（TB）的传播情况，我们开展了一项家庭接触者研究，以儿童作为结核分枝杆菌（MTB）近期传播的替代指标。通过这种方法，我们试图了解结核分枝杆菌复合群（MTBC）谱系的多样性、分布情况以及它们与暴露儿童结核病传播之间的关系。

方法

对2002年至2010年在一项家庭接触者研究中收集的15岁及以下儿童的MTBC分离株，使用LightCycler RT-PCR SNP基因分型检测法（LRPS）进行分析。所得的基因分型数据用于确定MTBC谱系与儿童临床和流行病学特征之间的关联。

结果与讨论

在接受调查的761名儿童中，9%（69/761）患有培养阳性结核病，这一估计值处于全球儿童结核病的范围内；其中71%（49/69）感染了“乌干达家族”的MTBC菌株，17%（12/69）感染了除MTBC乌干达家族之外的MTBC谱系4菌株，12%（8/69）感染了MTBC谱系3菌株，从而在研究区域不成比例地导致了结核病。总体而言，使用儿童作为结核病传播的替代指标，数据显示所研究的MTBC谱系与传播之间无相关性（OR = 0.304；P值 = 0.251；CI：95%；0.039 - 2.326）。