Is International Travel an Emerging Issue on Transmission of Beijing Lineage Mycobacterium tuberculosis?

Abstract

Mycobacterium tuberculosis belonging to Beijing sublineage (BL) is associated with high tuberculosis (TB) transmission, multidrug resistance, and adverse treatment outcomes. Sri Lanka experiences an increase in the number of travellers/workers to and from high TB-burden countries, and there is risk of getting BL strains imported into the country. In this context, a cohort study was conducted to assess the prevalence of BL strains among pulmonary tuberculosis (PTB) patients in the Kandy district of Sri Lanka (a popular tourist destination) and its association with patients’ sociodemographic and clinical characteristics. The study population included sputum smear-positive PTB patients diagnosed from February 2018–July 2019. Fresh sputum samples were collected for culturing and conducted polymerase chain reaction using BL-specific primers. Among the 101 patients recruited, presence of BL strains could be ascertained in 94 patients of which 24 (26%; 95% CI: 18%–35%) had BL strains. Prevalence of BL strains was higher among those with high sputum smear grades (2+ and 3+) (P<0.05) and those who had travelled abroad (P<0.05). The prevalence was also higher among young people (aged <35 years). Treatment success rates were similar in patients with (83%) and without BL strains (83% vs. 81%; P value = 0.8375). The prevalence of BL strains in Kandy, Sri Lanka, was high compared to previously reported figures in Sri Lanka, and the percentage drives closer to the countries in South East Asia. International travel raises itself as an emerging issue in BL transmission urging the need of policies and practices in immigration/emigration strategies. The study findings have the potential to alter the TB epidemiology in the country and might represent the situation in other underexplored countries as well. Therefore, it is important to monitor the trends and factors related to the prevalence of Beijing strains globally and make decisions as a whole.

Geno-Spatial Distribution of Mycobacterium Tuberculosis and Drug Resistance Profiles in Myanmar–Thai Border Area

“…We found that the L2 lineage had a high percentage of retreated cases, consistent with previous reports that showed this lineage to have a higher relapse rate and an association with drug resistance [ 9 , 28 , 29 ]. However, our finding of higher sputum grading in L1 lineage was not consistent with the finding of no association in South Africa study and higher grading of L2 in Sri Lanka study [ 30 , 31 ].…”

A Saudi Arabian Public Health Perspective of Tuberculosis

“…It is also important for those countries that have low TB burden but have a great influx of immigrants. There is a need to monitor the kinetics and trends of MTB lineages especially Beijing lineage and others that have well-documented drug resistance in order to devise appropriate actions to combat the associated risks [ 55 ].…”