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Pulmonary tuberculosis in Harare, Zimbabwe: analysis by spoligotyping
R S Heyderman1, M Goyal, P Roberts
1Department of Medicine, Medical School, University of Zimbabwe.
Thorax
|August 26, 1998
Summary
Spoligotyping, a molecular method, identified 20 Mycobacterium tuberculosis genotypes in Harare, Zimbabwe, despite limited culture facilities. This technique links tuberculosis strains to overcrowded living conditions, aiding epidemic understanding.
Area of Science:
- Medical Microbiology
- Epidemiology
- Molecular Biology
Background:
- Tuberculosis (TB) cases in Harare, Zimbabwe, have quadrupled in the last decade.
- Limited culture facilities hinder molecular epidemiology of TB transmission.
- Spoligotyping, a PCR-based method, offers an alternative without requiring TB culture.
Purpose of the Study:
- To evaluate spoligotyping for molecular fingerprinting of Mycobacterium tuberculosis in a high-burden setting.
- To assess the utility of spoligotyping in understanding TB transmission dynamics in Harare.
- To explore the relationship between TB genotypes and demographic/socioeconomic factors.
Main Methods:
- Adults with pulmonary TB and smear-positive sputum were enrolled.
- Demographic, socioeconomic, and clinical data were collected.
- Genomic DNA from sputum was analyzed using spoligotyping.
Main Results:
- Spoligotyping successfully identified 20 distinct Mycobacterium tuberculosis genotypes from 28 patients.
- Fifteen patients shared spoligotypes, with a higher prevalence in overcrowded conditions (OR 6.85, p=0.026).
- Two geographically related spoligotype clusters were identified from patients' rural family homes.
Conclusions:
- Spoligotyping provides valuable molecular typing data for TB in resource-limited settings.
- The technique shows potential for identifying transmission links, particularly with overcrowded living conditions.
- Further evaluation in larger epidemiological studies is recommended.