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Open Access Highly Accessed Research article

Diversity of Mycobacterium tuberculosis genotypes circulating in Ndola, Zambia

Chanda Mulenga12*, Isdore C Shamputa125, David Mwakazanga1, Nathan Kapata3, Françoise Portaels2 and Leen Rigouts24

Author Affiliations

1 Tropical Diseases Research Center, P.O. Box 71769, Ndola, Zambia

2 Institute of Tropical Medicine, 2000 Antwerpen, Belgium

3 Ministry of Health, National Tuberculosis and Leprosy Program, Lusaka, Zambia

4 Department of Pharmaceutical, Veterinary and Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium

5 Tuberculosis Research Section, National Institutes of Health, LCID/NIAID, Bethesda, MD 20892, USA

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BMC Infectious Diseases 2010, 10:177  doi:10.1186/1471-2334-10-177

Published: 17 June 2010

Abstract

Background

Tuberculosis (TB) is one of the major public health problems in Zambia. However, information about lineages of M. tuberculosis complex (MTBC) isolates useful for epidemiology investigations is unknown. In this study, we investigated the diversity of MTBC isolates from Ndola, a typical Zambian urbanized city with a documented high HIV prevalence.

Methods

This was part of a prospective cohort study in subjects with sputum smear-positive pulmonary TB. Spoligotyping was used to genotype the MTBC isolates and establish the circulating lineages. The 15-locus Mycobacterial Interspersed Repetitive Units - Variable Number Tandem Repeats (MIRU-VNTR) typing was used to study recent transmission.

Results

A total of 98 different spoligotypes were identified among 273 MTBC isolates. The majority (64.8%) of the isolates belonged to 9 known families, while 96 (35.2%) of the isolates were orphans. While LAM (41.8%) was the largest spoligotype family observed, most of the isolates (87.7%) belonging to the SAF1 family, with a significant portion coming from the T (13.6%), and X (5.9%) families. A few isolates (3.6%) belonged to the CAS, EAI, H, S, X1-LAM9 or U families. MIRU-VNTR typing was highly discriminatory (h = 0.988) among the 156 isolates tested in our sample, and increased the discrimination among 82 SAF1 isolates from 6 to 46 distinct patterns. In addition, 3.2% (5/156) of cases with available MIRU-VNTR results harbored more than one MTBC strain.

Conclusions

Our findings show a limited diversity of MTBC in Ndola with a high clustering rate (37.7%), which indicates that recent transmission plays an appreciable role in the dynamics of TB disease in this setting. This conclusion emphasizes the importance of early diagnosis and timely treatment. The results also confirm that MIRU-VNTR typing is suitable for studying the molecular epidemiology of TB in Ndola.