is a country where the molecular epidemiology of Mycobacterium tuberculosis (MTB) is poorly explored. Therefore, this study was performed to identify circulating lineages/sub-lineages of MTB and their transmission patterns. Methods: DNA was extracted from 89 isolates of MTB collected during 2012 and 2013 from new pulmonary tuberculosis patients in Kandy, Sri Lanka and analyzed by spoligotyping, large sequence polymorphism (LSP), mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing, and drug resistance-associated gene sequencing. Results: The predominant lineage was lineage 4 (Euro-American, 45.9%), followed by lineage 1 (Indo-Oceanic, 29.4%), lineage 2 (East-Asian, 23.5%), and lineage 3 (Central-Asian, 1.2%). Among 26 spoligotype patterns, eight were undesignated or new types and seven of these belonged to lineage 4. Undesignated lineage 4/SIT124 (n = 2/8) and SIT3234 (n = 8/8) clustered together based on 24-locus MIRU-VNTR typing. The dominant sub-lineage was Beijing/SIT1 (n = 19), with the isoniazid resistance katG G944C mutation (Ser315Thr) detected in two of them. Conclusions: The population structure of MTB in Kandy, Sri Lanka was different from that in the South Asian region. The clonal expansion of locally evolved lineage 4/SIT3234 and detection of the premultidrug resistant Beijing isolates from new tuberculosis patients is alarming and will require continuous monitoring.
Objectives Sri Lanka is a developing country where the majority of households still rely on firewood for cooking. Furthermore, the prevalence of anemia among reproductive-aged women is of moderate public health importance, according the classification of World Health Organization. Despite the researchers’ ongoing efforts to investigate a link between solid fuel smoke exposure and anemia, the veracity of their findings remains uncertain. As a result, the purpose of this study was to examine the relationship between biomass fuel smoke exposure and anemia in non-pregnant reproductive-aged women in Sri Lanka. Methods A descriptive cross-sectional study was conducted among 382 non-pregnant reproductive-aged (15 to 49 years) women in Central Province, Sri Lanka. Data was collected using a standardized interviewer-administered questionnaire, and exposure was assessed using a breath carbon monoxide monitor. Drabkin’s cynomethhemoglobin technique was used to determine blood hemoglobin concentration. Results The overall prevalence of anemia was 36.1%. The logistic regression model revealed no effect of cooking fuel type on anemic or non-anemic status after adjusting for potential confounding factors (p > 0.05). The multivariate regression analysis also discovered that cooking fuel type had no effect on women’s blood hemoglobin concentration. Conclusions The study results suggest no impact of solid fuel smoke exposure on anemia among non-pregnant, reproductive-aged women. Larger scale prospective cohort studies are recommended. The reasons behind the high prevalence of anemia among reproductive-aged women should be further investigated, and corrective measures should be implemented urgently.
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