Genomic Profiling of <i>Mycobacterium tuberculosis</i> Strains, Myanmar

Aung, Htin; Nyunt, Wint Wint; Fong, Yang; Biggs, Patrick J.; Winkworth, Richard C.; Lockhart, Peter J.; Yeo, Tsin Wen; Hill, Philip C.; Cook, Gregory M.; Aung, Si Thu

doi:10.3201/eid2711.210726

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…The prevalence of TB in the Yangon region is significantly higher than those in the states and other regions, despite better access to health services. The survey found that the transmission rate seemed to be high in congested urban areas, consistent with previous findings [14]. As Yangon is the economic and transportation hub of Myanmar, the movement of the population from the rural and remote areas is resulting in rapid changes in its environment [15].…”

Section: Plos Global Public Healthsupporting

confidence: 87%

The fourth national tuberculosis prevalence survey in Myanmar

Aung

Nyunt²,

Moe³

et al. 2022

PLOS Glob Public Health

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Tuberculosis (TB) remains a significant cause of morbidity and mortality in Myanmar. The fourth National TB Prevalence Survey was conducted in 2017–2018 to determine the actual burden of TB not only at the national level but also for three subnational strata (the states, regions other than Yangon, and the Yangon region) and develop a more efficacious country strategy on TB care and control. One hundred and thirty eight clusters were selected by population proportionate sampling. Adult (≥15 years of age) residents having lived for 2 weeks or more in the households of the selected clusters were invited to participate in the survey. The survey participants were screened for TB by a questionnaire and digital chest X-ray (CXR) after providing written informed consent. Individuals with a positive symptom screen and/or chest X-ray suggestive of TB were asked to provide sputum samples to test for Mycobacterium tuberculosis (Mtb) by Ziehl-Neelsen direct light microscopy, Xpert MTB/RIF Ultra (Xpert), and culture (Ogawa media). Bacteriologically confirmed TB cases were defined by an expert panel. Of 75 676 eligible residents, 66 480 (88%) participated, and 10 082 (15%) screened positive for TB. Among these, 322 participants were defined as bacteriologically confirmed TB cases. Cough lasting for two weeks or longer, one of the criteria used for screening for symptoms, could detect only 14% (45/322) of the study cases. The estimated prevalence of bacteriologically confirmed adult pulmonary TB was 468 (95% CI: 391–546) per 100,000. The prevalence was much higher among males, the older age group, urban Yangon and remote villages. In-depth interview with the participants on TB treatment showed that none of them was diagnosed in a TB health centre (primary care facilities). The prevalence of TB in Myanmar is still high due to challenges such as uncontrolled urbanization, an ageing population, migration, and poor access to health facilities in remote areas. New screening and diagnostic tools might help to detect more TB patients. There is a need to lay greater emphasis on multisectoral approaches, decentralization and the integration of basic TB services into primary care facilities.

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Section: Plos Global Public Healthsupporting

confidence: 87%

The fourth national tuberculosis prevalence survey in Myanmar

Aung

Nyunt²,

Moe³

et al. 2022

PLOS Glob Public Health

Self Cite

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“…To better understand the genetic structures and the role of recent transmission in these RR-TB strains, the phylogenetic tree was constructed based on nonredundant single-nucleotide polymorphisms (SNPs) using maximum-likelihood method ( 13 ). All RR-TB strains were phylogenetically classified according to the SNPs barcode nomenclature proposed by Coll et al ( 14 ).…”

Section: Resultsmentioning

confidence: 99%

Drug-Resistant Characteristics, Genetic Diversity, and Transmission Dynamics of Rifampicin-Resistant Mycobacterium tuberculosis in Hunan, China, Revealed by Whole-Genome Sequencing

Tan

Liu

et al. 2022

Microbiol Spectr

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“…In a study that occurred in Guangzhou Chest Hospital of China, 85.71% were RIF-resistant, of which 38% were MDR-TB [35]. A study from Myanmar showed 62% isolates had RIF resistance [36]. Between 85-90% of MTB has been reported that resistance to INH when it has the RIF resistance, and RIF resistance is regarded as a major marker of MDR [37].…”

Section: Discussionmentioning

confidence: 99%

Drug Resistance and Molecular Characteristics of Mycobacterium tuberculosis: A Single Center Experience

Chen

Feng

et al. 2022

JPM

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In recent years, the incidence of tuberculosis (TB) and mortality caused by the disease have been decreasing. However, the number of drug-resistant tuberculosis patients is increasing rapidly year by year. Here, a total of 380 Mycobacterium tuberculosis (MTB)-positive formalin-fixed and paraffin-embedded tissue (FFPE) specimens diagnosed in the Department of Pathology of the Eighth Medical Center, Chinese PLA General Hospital were collected. Among 380 cases of MTB, 85 (22.37%) were susceptible to four anti-TB drugs and the remaining 295 (77.63%) were resistant to one or more drugs. The rate of MDR-TB was higher in previously treated cases (52.53%) than in new cases [(36.65%), p < 0.05]. Of previously treated cases, the rate of drug resistance was higher in females than in males (p < 0.05). Among specimens obtained from males, the rate of drug resistance was higher in new cases than in previously treated cases (p < 0.05). Of mutation in drug resistance-related genes, the majority (53/380, 13.95%) of rpoB gene carried the D516V mutation, and 13.42% (51/380) featured mutations in both the katG and inhA genes. Among the total specimens, 18.68% (71/380) carried the 88 M mutation in the rpsL gene, and the embB gene focused on the 306 M2 mutation with a mutation rate of 19.74%. Among the resistant INH, the mutation rate of −15 M was higher in resistance to more than one drug than in monodrug-resistant (p < 0.05). In conclusion, the drug resistance of MTB is still very severe and the timely detection of drug resistance is conducive to the precise treatment of TB.

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Genomic Profiling of Mycobacterium tuberculosis Strains, Myanmar

Cited by 8 publications

References 27 publications

The fourth national tuberculosis prevalence survey in Myanmar

The fourth national tuberculosis prevalence survey in Myanmar

Drug-Resistant Characteristics, Genetic Diversity, and Transmission Dynamics of Rifampicin-Resistant Mycobacterium tuberculosis in Hunan, China, Revealed by Whole-Genome Sequencing

Drug Resistance and Molecular Characteristics of Mycobacterium tuberculosis: A Single Center Experience

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