Molecular epidemiology of tuberculosis in the Bata and Malabo districts of Equatorial Guinea
Source: The International Journal of Tuberculosis and Lung Disease, Volume 8, Number 12, December 2004 , pp. 1458-1463(6)
Abstract:SETTING: Bata and Malabo districts, Equatorial Guinea, 1 March 1999 to 28 February 2001.
OBJECTIVE: To study the molecular epidemiology of tuberculosis (TB).
RESULTS: During the study period, 429 patients were diagnosed with TB in the Bata and Malabo districts. A positive culture was obtained in 206 (48%) TB patients, with RFLP analysis being performed in 185 (89.8%). Ninety-two different patterns were identified. Single patterns were found in 71 strains (38.3%) and the remaining 114 strains (61.6%) were classified into 21 clusters (of 2 to 25 patients). In addition, 37 of the typing strains were resistant to one or more anti-tuberculosis drugs, and 30 were included in clusters (81%), with 21 low level isoniazid (MIC ≤1 μg/ml) resistance strains in the same cluster. Statistical analysis showed that resistance to anti-tuberculosis drugs (OR 3.1; 95%CI 1.2–7.6; P = 0.014), and positive smear results (4+ grade smear) (OR 4.3; 95%CI 1.5–12; P = 0.005), were significantly more frequent among patients with clustered strains. No epidemiological links were related to clustering.
CONCLUSIONS: The level of clustering (61.6%) observed suggests a high degree of recent transmission and a predominance of determined patterns of Mycobacterium tuberculosis strains among the population of Equatorial Guinea.
Document Type: Regular Paper
Affiliations: 1: Servei de Microbiologia, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain 2: Programa de Lucha contra la TB de Guinea Ecuatorial, Ministerio de Sanidad de Guinea Ecuatorial, Bata, Equatorial Guinea 3: Fundació CIDOB, Bata, Equatorial Guinea 4: Departament de Salut Pública, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
Publication date: December 1, 2004
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