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. 2016 Nov 21;16(1):687.
doi: 10.1186/s12879-016-2041-x.

Drug resistance and population structure of M.tuberculosis isolates from prisons and communities in Ethiopia

Solomon Ali  1   2 , Patrick Beckert  3   4 , Abraham Haileamlak  5 , Andreas Wieser  5   6   7 , Michael Pritsch  6 , Norbert Heinrich  6 , Thomas Löscher  6 , Michael Hoelscher  6   7 , Stefan Niemann  3   4 , Andrea Rachow  6   7
Affiliations

Drug resistance and population structure of M.tuberculosis isolates from prisons and communities in Ethiopia

Solomon Ali et al. BMC Infect Dis. .

Abstract

Background: The population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown.

Methods: A comparative cross sectional study was conducted on 126 MTBC strains isolated from prisons and communities in southwestern, southern and eastern Ethiopia. Phenotypic drug susceptibility testing was performed with the MGIT960 system. Combined 24-loci Mycobacterium interspersed repetitive unit-variable number tandem repeat and spacer oligonucleotide typing methods were used to study the MTBC population structure. The obtained data from prisons and communities were compared using statistical tests and regression analysis.

Results: A diverse population structure with 11 different lineages and sub-lineages was identified. The predominant strains were the recently described Ethiopia_H37Rv like (27.52%) and Ethiopia_3 (16.51%) with equal lineage distribution between prisons and communities. 28.57% of prison strains and 31.82% of community strains shared the identical genotype with at least one other strain. The multidrug-resistance (MDR) prevalence of the community was 2.27% whereas that of prisons was 9.52%. The highest mono resistance was seen against streptomycin (15.89%).

Conclusion: Tuberculosis in communities and prisons is caused by a variety of MTBC lineages with predominance of local Ethiopian lineages. The increasing prevalence of MDR MTBC strains is alarming. These findings suggest the need for new approaches for control of MDR tuberculosis in Ethiopia.

Keywords: Drug resistance; TB genotypes; TB in Ethiopia.

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Figures

Fig. 1
Fig. 1
Radial UPGMA tree based on the copy numbers of MIRU-VNTR 24-loci. Inner circle: lineages and sub-lineages, (EAI - East African Indian, LAM - Latin American Mediterranean, CAS - Central Asia). Small rectangles in the second circle: drug resistance pattern of the individual isolates (green - fully susceptible, red - MDR, blue - resistant but not MDR). Small rectangles in the third circle: origin of the patient (green - community participant, red - prisoner). Small rectangle in the fourth circle: clustering according to 24-loci MIRU-VNTR and spoligotyping pattern analysis; isolates with identical genotyping profile are highlighted in same color. Outer circle: MLVA MTBC 15–9 code
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