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Long-term dominance of Mycobacterium tuberculosisUganda family in peri-urban Kampala-Uganda is not associated with cavitary disease

Year: 2013
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Previous studies have shown that Mycobacterium tuberculosis (MTB) Uganda family, a sub-lineage of the MTB Lineage 4, is the main cause of tuberculosis (TB) in Uganda. Using a well characterized patient population, this study sought to determine whether there are clinical and patient characteristics associated with the success of the MTB Uganda family in Kampala. METHODS: A total of 1,746 MTB clinical isolates collected from 1992-2009 in a household contact study were genotyped. Genotyping was performed using Single Nucleotide Polymorphic (SNP) markers specific for the MTB Uganda family, other Lineage 4 strains, and Lineage 3, respectively. Out of 1,746 isolates, 1,213 were from patients with detailed clinical data. These data were used to seek associations between MTB lineage/sub-lineage and patient phenotypes. RESULTS: Three MTB lineages were found to dominate the MTB population in Kampala during the last two decades. Overall, MTB Uganda accounted for 63% (1,092/1,746) of all cases, followed by other Lineage 4 strains accounting for 22% (394/1,746), and Lineage 3 for 11% (187/1,746) of cases, respectively. Seventy-three (4 %) strains remained unclassified. Our longitudinal data showed that MTB Uganda family occurred at the highest frequency during the whole study period, followed by other Lineage 4 strains and Lineage 3. To explore whether the long-term success of MTB Uganda family was due to increased virulence, we used cavitary disease as a proxy, as this form of TB is the most transmissible. Multivariate analysis revealed that even though cavitary disease was associated with known risk factors such as smoking (adjusted odds ratio (aOR) 4.8, 95% confidence interval (CI) 3.33-6.84) and low income (aOR 2.1, 95% CI 1.47-3.01), no association was found between MTB lineage and cavitary TB. CONCLUSION: The MTB Uganda family has been dominating in Kampala for the last 18 years, but this long-term success is not due to increased virulence as defined by cavitary disease.
DOI: 10.1186/1471-2334-13-484
Authors: Eddie M Wampande, Ezekiel Mupere, Sara M Debanne, Benon B Asiimwe, Mary Nsereko, Harriet Mayanja, Kathleen Eisenach, Gilla Kaplan, Henry W Boom, Sebastien Gagneux, Moses L Joloba
Institutions: Makerere University, Case Western Reserve University, University of Arkansas for Medical Sciences, University Hospitals of Cleveland, Swiss Tropical and Public Health Institute, University of Basel
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,090
Funders: National Science Foundation, Carnegie Corporation of New York, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Institutes of Health, Johnson Cancer Research Center, Kansas State University, National Institute of Allergy and Infectious Diseases
Awards: TUBERCULOSIS RESEARCH UNIT (TBRU), G183426229, Integrating Genomic and Ecologic Approaches to Understand the Nature and Consequence of Genetic Diversity in Mycobacterium tuberculosis, TUBERCULOSIS PREVENTION RESEARCH UNIT, G5094035162, G7449386978, CELL TO CELL SIGNALING IN MYCOBACTERIA, G830744229, G9000188885
OpenAlex ID: W1987246500
FWCI: 4.262
Cites: 68
Cited by: 42
Related to: 10