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Genetic diversity, transmission dynamics and drug resistance of Mycobacterium tuberculosis in Angola

Publication . Perdigão, João; Clemente, Sofia; Ramos, Jorge; Masakidi, Pedro; Machado, Diana; Silva, Carla; Couto, Isabel; Viveiros, Miguel; Taveira, Nuno; Portugal, Isabel

"Tuberculosis (TB) poses a serious public health problem in Angola. No surveillance data on drug resistance is available and nothing is known regarding the genetic diversity and population structure of circulating Mycobacterium tuberculosis strains. Here, we have genotyped and evaluated drug susceptibility of 89 Mycobacterium tuberculosis clinical isolates from Luanda. Thirty-three different spoligotype profiles corresponding to 24 different Shared International Types (SIT) and 9 orphan profiles were detected. SIT 20 (LAM1) was the most prevalent (n = 16, 18.2%) followed by SIT 42 (LAM9; n = 15, 17.1%). Overall, the M. tuberculosis population structure in this sample was dominated by LAM (64.8%) and T (33.0%) strains. Twenty-four-loci MIRU-VNTR analysis revealed that a total of 13 isolates were grouped in 5 distinct clusters. Drug susceptibility data showed that 22 (24.7%) of the 89 clinical isolates were resistant to one or more antibacillary drugs of which 4 (4.5%) were multidrug resistant. In conclusion, this study demonstrates a high predominance of LAM strains circulating in the Luanda setting and the presence of recent transmission events. The rate and the emergence dynamics of drug resistant TB found in this sample are significant and highlight the need of further studies specifically focused on MDR-TB transmission."

2017-02Journal article

Open access

Drug resistance and genetic diversity of Mycobacterium tuberculosis in Luanda, Angola: a molecular epidemiological perspective

Publication . Perdigão, João; Clemente, Sofia; Ramos, Jorge; Masakidi, Pedro; Machado, Diana; Silva, Carla; Couto, Isabel; Viveiros, Miguel; Taveira, Nuno; Portugal, Isabel

"Sub-saharan Africa contributes heavily to the tuberculosis (TB) burden worldwide. According to the World Health Organization (WHO), Africa exhibits the highest TB regional incidence rate (280 cases per 100 000 habitants) and the highest Human Immunodeficiency Virus co-infection rate (34%), both of which mostly driven by sub-saharan African countries (4). Yet, to this date, Angola has no surveillance data regarding drug resistance and the latest WHO estimates point to the occurrence of 69 000 new cases in 2013 and an incidence rate of 320 cases per 100 000 habitants in the same period (4). Additionally nothing is known regarding the genetic diversity and population structure of circulating Mycobacterium tuberculosis (M. tuberculosis) strains. Its capital city, Luanda, harbours approximately 33.7% of the country’s population and is responsible for one-third of the TB cases nationwide. In the present study, we have addressed the genetic diversity and drug susceptibility profiles of circulating M. tuberculosis strains recovered from patients followed at a central Luanda hospital unit."

2015-06-28Conference object

Open access