Mfinanga Sayoki G M, Warren Rob M, Kazwala Rudovick, Kahwa Amos, Kazimoto Thecla, Kimaro Godfather, Mfaume Said, Chonde Timothy, Ngadaya Esther, Egwaga Said, Streicher Elizabeth M, Van Pittius Gey N C, Morkve Odd, Cleaveland Sarah
Tanzan J Health Res. 2014 Apr;16(2):58-69. doi: 10.4314/thrb.v16i2.1.
Information on the different spoligotype families of Mycobacterium tuberculosis in Tanzania is limited, and where available, restricted to small geographical areas. This article describes the genetic profile of M tuberculosis across Tanzania and suggests how spoligotype families might affect drug resistance and treatment outcomes for smear positive pulmonary tuberculosis patients in Tanzania. We conducted the study from 2006 to 2008, and the isolates were obtained from samples collected under the routine drug resistance surveillance system. The isolates were from specimens collected from 2001 to 2007, and stored at the Central and Reference Tuberculosis Laboratory. A total of 487 isolates from 23 regions in the country were spoligotyped. We were able to retrieve clinical information for 446 isolates only. Out of the 487 isolates spoligotyped, 195(40.0%) belonged to the Central Asian (CAS) family, 84 (17.5%) to the Latin American Mediterranean (LAM) family, 49 (10.1%) to the East-African Indian (EAI) family, and 33 (6.8%) to the Beijing family. Other isolates included 1 (0.2%) for H37Rv, 10 (2.1%) for Haarlem, 4 (0.8%) for S family, 58 (11.9%) for T family and 52 (10.7%) for unclassified. No spoligotype patterns were consistent with M bovis. Regarding treatment outcomes, the cure rate was 80% with no significant variation among the spoligotype families. The overall level of MDR TB was 2.5% (3/12 1), with no significant difference among the spoligotype families. All Beijing strains (11.8%, 30/254) originated from the Eastern and Southern zones of the country, of which 80% were from Dar es Salaam. Isolates from the CAS and T families were reported disproportionately from the Eastern-Southern zone, and EAI and LAM families from the Northern-Lake zones but the difference was not statistically significant. Five isolates were identified as non-tuberculous Mycobacteria. In conclusion, M. tuberculosis isolates from pulmonary tuberculosis cases in Tanzania were classified mostly within the CAS, LAM, and EAI and T families, while the Beijing family comprised about 7% isolates only. Consistently good treatment outcomes were recorded across these spoligotype families. The proportion of drug resistance strains was low. The findings also suggest variation of spoligotype families with varying geographical localities within the country, and identify this area for further research to confirm this finding.
坦桑尼亚关于结核分枝杆菌不同间隔寡核苷酸分型家族的信息有限，即便有相关信息，也仅限于小地理区域。本文描述了坦桑尼亚全国范围内结核分枝杆菌的基因图谱，并提出间隔寡核苷酸分型家族可能如何影响坦桑尼亚涂片阳性肺结核患者的耐药性和治疗结果。我们于2006年至2008年开展了这项研究，分离株取自常规耐药监测系统下收集的样本。这些分离株来自2001年至2007年采集的标本，保存在中央和参考结核病实验室。对该国23个地区的487株分离株进行了间隔寡核苷酸分型。我们仅能检索到446株分离株的临床信息。在487株进行间隔寡核苷酸分型的分离株中，195株（40.0%）属于中亚（CAS）家族，84株（17.5%）属于拉丁美洲地中海（LAM）家族，49株（10.1%）属于东非印度（EAI）家族，33株（6.8%）属于北京家族。其他分离株包括1株（0.2%）为H37Rv，10株（2.1%）为哈勒姆型，4株（0.8%）为S家族，58株（11.9%）为T家族，52株（10.7%）为未分类型。没有间隔寡核苷酸分型模式与牛分枝杆菌一致。关于治疗结果，治愈率为80%，各间隔寡核苷酸分型家族之间无显著差异。耐多药结核病的总体水平为2.5%（3/121），各间隔寡核苷酸分型家族之间无显著差异。所有北京菌株（11.8%，30/254）均来自该国东部和南部地区，其中80%来自达累斯萨拉姆。来自CAS和T家族的分离株在东部 - 南部地区的报告比例过高，而EAI和LAM家族在北部 - 湖区，但差异无统计学意义。5株分离株被鉴定为非结核分枝杆菌。总之，坦桑尼亚肺结核病例中的结核分枝杆菌分离株大多归类于CAS、LAM、EAI和T家族，而北京家族仅占分离株的约7%。这些间隔寡核苷酸分型家族的治疗结果始终良好。耐药菌株的比例较低。研究结果还表明间隔寡核苷酸分型家族在该国不同地理区域存在差异，并确定该领域有待进一步研究以证实这一发现。
