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Spatio-Temporal Distribution of Mycobacterium tuberculosis Complex Strains in Ghana.

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Genomic differences in Mycobacterium tuberculosis complex (MTBC) species impact TB control. This study analyzed MTBC prevalence and spatial distribution in Ghana, finding M. tuberculosis sensu stricto and M. africanum dominant, with no decline in M. africanum.

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Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Genomic variations within the Mycobacterium tuberculosis complex (MTBC) may influence tuberculosis (TB) control strategies.
  • Understanding the prevalence and spatial distribution of MTBC species and lineages is crucial for targeted interventions.

Purpose of the Study:

  • To analyze the prevalence and spatial distribution of MTBC species and lineages in Ghana between 2007 and 2014.
  • To investigate potential geographical variations in MTBC species and lineage prevalence.

Main Methods:

  • Isolates from pulmonary TB patients were identified and confirmed as MTBC using PCR.
  • Spoligotyping and large sequence polymorphism (LSP) PCR were employed to determine MTBC lineages.
  • Spatial analysis using SaTScan and ArcMap identified significant lineage clusters and their geographical distribution.

Main Results:

  • M. tuberculosis sensu stricto (MTBss) accounted for 79.1% and M. africanum (Maf) for 20.2% of the 2,551 MTBC isolates.
  • M. bovis prevalence was significantly higher in Northern Ghana compared to Southern Ghana (p = 0.020).
  • Seven significant MTBC lineage clusters were identified, with Ghana and Cameroon sub-lineages associated with northern and southern regions, respectively.

Conclusions:

  • M. tuberculosis sensu stricto and M. africanum are the primary causes of TB in Ghana, with stable prevalence over the study period.
  • Unlike some West African nations, Ghana did not show a decline in M. africanum prevalence.
  • Geographical clustering of specific MTBC lineages was observed, highlighting regional variations.