The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance

Gehre, Florian; Otu, Jacob; Kendall, Lindsay; Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Kehinde, Aderemi; Adebiyi, Oludele; Salako, Kayode; Baldeh, Ignatius; Jallow, Aisha; Jallow, Mamadou; Dagnra, Anoumou; Disse, K.; Kadanga, Essosimna A.; Idigbe, Emmanuel O.; Onubogu, Catherine; Onyejepu, Nneka; Gaye-Diallo, Aïssatou; Ba-Diallo, Awa; Rabna, Paulo; Mané, Morto; Sanogo, Moumine; Diarra, Bassirou; Zingué, Dezemon; Sanou, Adama; Senghore, Madikay; Kwambana-Adams, Brenda; Demba, Edward; Faal-Jawara, Tutty Isatou; Kumar, Samrat; Tientcheu, Leopold D.; Jallow, Adama; Ceesay, Samba; Adetifa, Ifedayo; Jaye, Assan; Pallen, Mark J.; D’Alessandro, Umberto; Kampmann, Beate; Adegbola, Richard A.; Mboup, Souleymane; Corrah, Tumani; Jong, Bouke C. de; Antonio, Martín

doi:10.1186/s12916-016-0704-5

Cited by 40 publications

(50 citation statements)

References 12 publications

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“…in 2016 reported an equally distribution of polyphyletic T1 across West African countries, but was not the predominant one in most of these countries. [14] Beyond our West African region, MTB LAM or MTB Cameroon was consistently reported to be the most frequent in Cameroun. [4,15–17] We found eight (1.8%) strains of MTB Beijing with a slight increased proportion compared to Traore et al .’s report of 2012 (1.6%) [3] while a higher prevalence of 10.3% was reported in Benin.…”

Section: Discussionmentioning

confidence: 96%

The most frequent Mycobacterium tuberculosis complex families in mali (2006–2016) based on spoligotyping

Togo

Kodio

Diarra

et al. 2017

Int J Mycobacteriol

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Objective To identify strains of Mycobacterium tuberculosis complex (MTBc) circulating in Bamako region during the past 10 years. Materials and Methods From 2006 to 2016, we conducted a cross-sectional study to identify with spoligotyping, clinical isolates from tuberculosis (TB)-infected patients at different stages of their treatments in Bamako, Mali. Results Among the 904 suspected TB patients included in the study and thereafter tested in our BSL-3 laboratory, 492 (54.4%) had MTBc and therefore underwent spoligotyping. Overall, three subspecies, i.e., MTB T1 (31.9%) and MTB LAM10 (15.3%) from lineage 4 and M. africanum 2 (16.8%) from lineage 6 were the leading causes of TB in Bamako region during the past 10 years. Other spoligotypes such as MTB T3, MTB Haarlem 2, MTB EAI3, and MTB family 33 were also commonly seen from 2010 to 2016. Conclusion This study showed a high genetic diversity of strains isolated in Bamako region and highlights that M. tuberculosis T1 strain was the most prevalent. Furthermore, the data indicate an increasing proportion of primary drug resistance overtime in Bamako.

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Section: Discussionmentioning

confidence: 96%

The most frequent Mycobacterium tuberculosis complex families in mali (2006–2016) based on spoligotyping

Togo

Kodio

Diarra

et al. 2017

Int J Mycobacteriol

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“…The protocol, including bacterial sub-studies, was approved by the Joint Gambia Government/MRC Ethics Committee and the Institute of Tropical Medicine, Antwerp Institutional Review Board. Nigerian isolates were collected from Southwest Nigeria within the West African Node of Excellence for TB, AIDS and Malaria (WANETAM) with the recommendations of the University of Ibadan and University College Hospital, Ibadan Joint Ethical Review Committees and the Nigerian Institute of Medical Research, Institutional Board (36). All subjects gave written informed consent in accordance with the Declaration of Helsinki and were anonymized.…”

Section: Methodsmentioning

confidence: 99%

“…Of this dataset, we analyzed the whole genome sequences of all 280 MAF L6 strains, the 3 MAF L5 isolated from The Gambia and the 6 MAF L5 from Nigeria, resulting in a total 289 MAF strains. For the MTB lineages, we analyzed a total 205 strains consisting of all 19 MTB L1, all 10 MTB L3 and 14 MTB L4 Ghana, 35 MTB L2 and a random number of L4 Haarlem (44), Cameroon (36) and LAM (46), while ensuring that all MTB L4 sublineages isolated were represented and isolates from each year of isolation, 2012 to 2014, were included.…”

Section: Methodsmentioning

confidence: 99%

Comparative Genomics Shows Differences in the Electron Transport and Carbon Metabolic Pathways ofMycobacterium africanumrelative toMycobacterium tuberculosisand suggests an adaptation to low oxygen tension

Ofori-Anyinam

Riley

Jobarteh

et al. 2019

Preprint

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Pathways of Mycobacterium africanum relative to Mycobacterium tuberculosis and suggests an 3 adaptation to low oxygen tension 4 5 Summary: 27 The geographically restricted M. africanum lineages (MAF) are primarily found in West Africa, where 28 they account for a significant proportion of tuberculosis. Despite this phenomenon, little is known 29 about the co-evolution of these ancient lineages with West Africans. MAF and M. tuberculosis sensu 30 stricto lineages (MTB) differ in their clinical, in vitro and in vivo characteristics for reasons not fully 31 understood. Therefore, we compared genomes of 289 MAF and 205 MTB clinical isolates from the 32 6 main human-adapted M. tuberculosis complex lineages, for mutations in their Electron Transport 33 Chain and Central Carbon Metabolic pathway in an attempt to explain these metabolic differences. 34 Furthermore, we determined, in silico, whether each mutation could affect the function of genes 35 encoding enzymes in these pathways. 36 We found more potentially deleterious mutations in these pathways in MAF lineages compared to 37 MTB lineages. Additionally, we found that convergent evolution in these pathways occurred 38 between MAF and some MTB lineages. 39 Generally, our findings show further differences between MAF and MTB lineages that may have 40 contributed to the MAF clinical-and growth phenotype and may indicate potential adaptation of 41 MAF lineages to a distinct ecological niche, that we suggest may include areas characterized by low 42 oxygen tension. 43 44 Running title: The M. africanum respiratory chain and carbon metabolic pathway 45 46 Transport, Carbon Metabolism 48 49 50 51 3 1 Introduction 52 The Mycobacterium tuberculosis complex (MTBC) consists of a group of human-adapted ecotypes-53 Mycobacterium tuberculosis sensu stricto, Mycobacterium africanum, Mycobacterium canetti and 54 animal-adapted ecotypes (1-4). There are seven known MTBC lineages (L) associated with particular 55 geographic regions and adapted to specific human populations. These are the five lineages that 56 make up M. tuberculosis sensu stricto (lineages 1-4 and lineage 7) and the two M. africanum lineages 57 (lineages 5 and 6). Africa uniquely has a representation of all seven lineages. 58 MTBC strains from the seven lineages differ on average by about 1200 single nucleotide 59 polymorphisms (5), with clear distinction between MAF and MTB lineages (6-8). 60 MTB Lineages 2 and 4 are more widespread geographically, more pathogenic and more 61 transmissible, while MAF Lineages are exclusively found in West Africa and less transmissible (5, 9, 62 10). Clinically, MTB L4 is relatively more virulent than MAF L6 as evidenced by significantly faster 63 progression, in contacts of infectious cases, to active disease (11). MAF lineages are associated with 64 extrapulmonary disease and MAF L6 more commonly causes disease in immunocompromised 65 persons and those with lower Body Mass Index, implying a more opportunistic pathogen (10, 12). 66 Furthermore, MAF L5 a...

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“…The paucity of data from outside of southern Africa is a concern and may reflect limited research resources available among west, central and east African countries. Lack of infrastructure, equipment, human resources and absence of good health information system [5,18] in TB programs have been advanced as reasons for paucity in MDR-TB data and studies conducted in SSA. The number of publications on treatment outcomes for MDR-TB and HIV coinfection in SSA are low and the quality of studies is generally weak when compared to those in similar global reviews [6,18,32].…”

Section: Limitationmentioning

confidence: 99%

Treatment outcomes and antiretroviral uptake in Multidrug-Resistant Tuberculosis and HIV coinfected Patients in Sub Saharan Africa. A Systematic Review and Meta-Analysis

Chem

Hout

Hope

2019

Preprint

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Background: Multidrug-resistant tuberculosis (MDR-TB) in HIV endemic settings is a major threat to public health. MDR-TB is a substantial and underreported problem in Sub-Saharan Africa (SSA), with recognised cases projected to increase with advancement in diagnostic technology. There is paucity of review evidence on treatment outcomes and antiretroviral (ART) uptake among MDR-TB patients with HIV in SSA. To address this gap a review of treatment outcomes in HIV patients co-infected with MDR-TB in the SSA region was undertaken. eligibility and data extracted. Random effect meta-analysis was conducted using STATA and Cochrane's review manager.Results: A total of 271 publications were identified of which nine fulfilled the inclusion criteria. Data was collected from 3368 MDR-TB and HIV co-infected patients from four SSA countries; South Africa (6), Lesotho (1), Botswana (1) and Ethiopia (1). The most common outcome was cure (34.9% cured in the pooled analysis), this was followed by death (18.1% in pooled analysis). ART uptake was high, at 83% in the pooled analysis. Cure ranged from 28.6 to 54.7% among patients on ART and from 22.2 to 57.7% among those not on ART medication. MDR-TB and HIV coinfected patients were less likely to be successfully treated than HIV negative MDR-TB patients (Risk Ratio = 0.87, 95% CI 0.97, 0.96).Conclusion: Treatment outcomes for MDR-TB and HIV co-infected patients do not vary widely from those reported globally. However, treatment success was lower among HIV positive MDR-TB patients compared to HIV negative MDR-TB patients. Prompt antiretroviral initiation and interventions to improve treatment adherence are necessary.

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The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance

Cited by 40 publications

References 12 publications

The most frequent Mycobacterium tuberculosis complex families in mali (2006–2016) based on spoligotyping

The most frequent Mycobacterium tuberculosis complex families in mali (2006–2016) based on spoligotyping

Comparative Genomics Shows Differences in the Electron Transport and Carbon Metabolic Pathways ofMycobacterium africanumrelative toMycobacterium tuberculosisand suggests an adaptation to low oxygen tension

Treatment outcomes and antiretroviral uptake in Multidrug-Resistant Tuberculosis and HIV coinfected Patients in Sub Saharan Africa. A Systematic Review and Meta-Analysis

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