Molecular diversity of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mozambique

Abstract

Background: Mozambique is one of the countries with the highest burden of tuberculosis (TB) in Sub-Saharan Africa, and information on the predominant genotypes of Mycobacterium tuberculosis circulating in the country are important to better understand the epidemic. This study determined the predominant strain lineages that cause TB in Mozambique.

Results: A total of 445 M. tuberculosis isolates from seven different provinces of Mozambique were characterized by spoligotyping and resulting profiles were compared with the international spoligotyping database SITVIT2.The four most predominant lineages observed were: the Latin-American Mediterranean (LAM, n = 165 or 37%); the East African-Indian (EAI, n = 132 or 29.7%); an evolutionary recent but yet ill-defined T clade, (n = 52 or 11.6%); and the globally-emerging Beijing clone, (n = 31 or 7%). A high spoligotype diversity was found for the EAI, LAM and T lineages.

Conclusions: The TB epidemic in Mozambique is caused by a wide diversity of spoligotypes with predominance of LAM, EAI, T and Beijing lineages.

Figure 1

Geographical distribution of M. tuberculosis predominant spoligotype lineages in 7 provinces of Mozambique. The map describes the geographical distribution of predominant spoligotype lineages in Maputo city, Maputo province, Gaza, Inhambane, Nampula, Cabo Delgado and Niassa. The number of isolates per lineage in each province is depicted. Lineages: Latin American Mediterranean (LAM); East African Indian (EAI); T lineage; Beijing; Haarlem (H) strains; X clade; Central Asian strains (CAS); S lineage, and the "Manu" lineage.

Figure 2

The principal genetic groups (PGG) in Mozambique. The figure illustrates the 4 most predominant clades in our study comprised both PGG1 and PGG2/3 lineages: LAM (PGG 2/3); ancestral EAI (PGG1); T clade (PGG 2/3); and the globally-emerging Beijing clone (PGG1).