Molecular Epidemiology of Mycobacterium tuberculosis strains isolated from pulmonary tuberculosis patients in south Ethiopia

  • Yared Merid College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
  • Elena Hailu Armauer Hansen Research Institute, Addis Ababa, Ethiopia
  • Getnet Habtamu Armauer Hansen Research Institute, Addis Ababa, Ethiopia
  • Melaku Tilahun Armauer Hansen Research Institute, Addis Ababa, Ethiopia
  • Markos Abebe Armauer Hansen Research Institute, Addis Ababa, Ethiopia
  • Mesay Hailu College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
  • Tsegaye Hailu Armauer Hansen Research Institute, Addis Ababa, Ethiopia
  • Daniel Gemechu Datiko Management Sciences for Health, Addis Ababa, Ethiopia
  • Yimtubezinash Woldeamanuel College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • Abraham Aseffa Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Keywords: Molecular epidemiology, Tuberculosis, drug susceptibility testing, geospatial cluster, Ethiopia

Abstract

Introduction: Understanding the epidemiology of tuberculosis is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing patterns and genetic diversity of M. tuberculosis isolates in southern Ethiopia.

Methodology: A cross-sectional study was conducted among newly diagnosed sputum smear positive patients with tuberculosis visiting nine health facilities in southern Ethiopia from June 2015 to May 2016. Three consecutive sputum samples (spot-morning-spot) per patient were examined using acid-fast bacilli smear microscopy with all smear positive specimens having acid-fast bacilli cultures performed. M. tuberculosis isolates had drug susceptibility testing performed using indirect proportion method and were genotyped with RD9 deletion analysis and spoligotyping. Mapping of strain was made using geographic information system.

Results: Among 250 newly diagnosed patients with tuberculosis, 4% were HIV co-infected. All 230 isolates tested were M. tuberculosis strains belonging to three lineages: Euro-American, 187 (81%), East-African-Indian, 31 (14%), and Lineage 7 (Ethiopian lineage), 8 (4%); categorized into 63 different spoligotype patterns, of which 85% fell into 28 clusters. M. tuberculosis strains were clustered by geographic localities. The dominant spoligotypes were SIT149 (21%) and SIT53 (19%). Drug susceptibility testing found that 14% of isolates tested were resistant to > 1 first line anti- tuberculosis drugs and 11% to INH. SIT 149 was dominant among drug resistant isolates.

Conclusions: The study revealed several clusters and drug resistant strains of M. tuberculosis in the study area, suggesting recent transmission including of drug resistant tuberculosis. Wider monitoring of drug susceptibility testing and geospatial analysis of transmission trends is required to control tuberculosis in southern Ethiopia.

Author Biographies

Elena Hailu, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

 

Getnet Habtamu, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

Melaku Tilahun, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

Markos Abebe, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

Mesay Hailu, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia

Co-author

Tsegaye Hailu, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

Daniel Gemechu Datiko, Management Sciences for Health, Addis Ababa, Ethiopia

Co-author

Yimtubezinash Woldeamanuel, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Co-author

Abraham Aseffa, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Co-author

Published
2021-09-30
How to Cite
1.
Merid Y, Hailu E, Habtamu G, Tilahun M, Abebe M, Hailu M, Hailu T, Datiko DG, Woldeamanuel Y, Aseffa A (2021) Molecular Epidemiology of Mycobacterium tuberculosis strains isolated from pulmonary tuberculosis patients in south Ethiopia. J Infect Dev Ctries 15:1299-1307. doi: 10.3855/jidc.14742
Section
Original Articles