Molecular epidemiology of M. tuberculosis in Ethiopia: A systematic review and meta-analysis
The molecular epidemiology of Mycobacterium tuberculosis (M. tuberculosis, Mtb) is poorly documented in Ethiopia. The data that exists has not yet been collected in an overview metadata form. Thus, this review summarizes available literature on the genomic diversity, geospatial distribution and tran...
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| Published in: | Tuberculosis (Edinburgh, Scotland) Vol. 118; p. 101858 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Scotland
Elsevier Ltd
01-09-2019
Elsevier Science Ltd |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The molecular epidemiology of Mycobacterium tuberculosis (M. tuberculosis, Mtb) is poorly documented in Ethiopia. The data that exists has not yet been collected in an overview metadata form. Thus, this review summarizes available literature on the genomic diversity, geospatial distribution and transmission patterns of Mtb lineages (L) and sublineages in Ethiopia. Spoligotyping and Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) based articles were identified from MEDLINE via PubMed and Scopus. The last date of article search was done on 12th February 2019. Articles were selected following the PRISMA flow diagram. The proportion of (sub)lineages was summarized at national level and further disaggregated by region. Clustering and recent transmission index (RTI) were determined using metan command and random effect meta-analysis model. The meta-analysis was computed using Stata 14 (Stata Corp. College Station, TX, USA). Among 4371 clinical isolates, 99.5% were Mtb and 0.5% were M. bovis. Proportionally, L4, L3, L1 and L7 made up 62.3%, 21.7%, 7.9% and 3.4% of the total isolates, respectively. Among sublineages, L4.2. ETH/SIT149, L4.10/SIT53, L3. ETH1/SIT25 and L4.6/SIT37 were the leading clustered isolates accounting for 14.4%, 9.7%, 7.2% and 5.5%, respectively. Based on MIRU-VNTR, the rate of clustering was 41% and the secondary case rate from a single source case was estimated at 29%. Clustering and recent transmission index was higher in eastern and southwestern Ethiopia compared with the northwestern part of the country. High level of genetic diversity with a high rate of clustering was noted which collectively mirrored the phenomena of micro-epidemics and super-spreading. The largest set of clustered strains deserves special attention and further characterization using whole genome sequencing (WGS) to better understand the evolution, genomic diversity and transmission dynamics of Mtb. |
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| Bibliography: | Authors’ contributions DM: Conceptualization, formal analysis, methodology, writing original draft, writing review & editing. AD: Data curation, methodology, writing original draft, writing review & editing. AC: Formal analysis, contribute software, participate in design. AS, FB, EN, AM: Participated in the data extraction, writing the draft and reviewing the final manuscript. AM, LW, KB, YK: Drafting the protocol, drafting and reviewing the final manuscript. SYA: Participated in the investigation of the draft, validation, drafting and reviewing of the final manuscript. TT: Participated in supervision, validation and reviewing of the final manuscript. AA: Conceived the review topic, reviewed the protocol, supervised the review process, reviewed, investigated and validated the final manuscript. |
| ISSN: | 1472-9792 1873-281X |
| DOI: | 10.1016/j.tube.2019.101858 |