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Molecular epidemiology of tuberculosis in the Bata and Malabo districts of Equatorial Guinea

Authors: Tudó, G.1; González-Martín, J.1; Obama, R.2; Rodríguez, J. M.3; Franco, J. R.3; Espasa, M.1; Simarro, P. P.3; Escaramís, G.4; Ascaso, C.4; García, A.1; Jiménez De Anta, M. T.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 8, Number 12, December 2004 , pp. 1458-1463(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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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.

Keywords: Africa; molecular epidemiology; transmission; tuberculosis

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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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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