Molecular Epidemiology, Drug Susceptibility and Economic Aspects of Tuberculosis in Mubende District, Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Tuberculosis (TB) remains a global public health problem whose effects have major impact in developing
countries like Uganda. This study aimed at investigating genotypic characteristics and drug resistance profiles of
Mycobacterium tuberculosis isolated from suspected TB patients. Furthermore, risk factors and economic burdens that could
affect the current control strategies were studied.
Methods: TB suspected patients were examined in a cross-sectional study at the Mubende regional referral hospital
between February and July 2011. A questionnaire was administered to each patient to obtain information associated with
TB prevalence. Isolates of M. tuberculosis recovered during sampling were examined for drug resistance to first line anti-TB
drugs using the BACTEC-MGIT960TMsystem. All isolates were further characterized using deletion analysis, spoligotyping
and MIRU-VNTR analysis. Data were analyzed using different software; MIRU-VNTR plus, SITVITWEB, BioNumerics and
multivariable regression models.
Results: M. tuberculosis was isolated from 74 out of 344 patients, 48 of these were co-infected with HIV. Results from the
questionnaire showed that previously treated TB, co-infection with HIV, cigarette smoking, and overcrowding were risk
factors associated with TB, while high medical related transport bills were identified as an economic burden. Out of the 67
isolates that gave interpretable results, 23 different spoligopatterns were detected, nine of which were novel patterns. T2
with the sub types Uganda-I and Uganda-II was the most predominant lineage detected. Antibiotic resistance was detected
in 19% and multidrug resistance was detected in 3% of the isolates.
Conclusion: The study detected M. tuberculosis from 21% of examined TB patients, 62% of whom were also HIV positive.
There is a heterogeneous pool of genotypes that circulate in this area, with the T2 lineage being the most predominant.
High medical related transport bills and drug resistance could undermine the usefulness of the current TB strategic
interventions.
Description
Keywords
Molecular Epidemiology, Drug Susceptibility, Tuberculosis, Mubende District, Uganda
Citation
Muwonge A, Malama S, Johansen TB, Kankya C, Biffa D, et al. (2013) Molecular Epidemiology, Drug Susceptibility and Economic Aspects of Tuberculosis in Mubende District, Uganda. PLoS ONE 8(5): e64745. doi:10.1371/journal.pone.0064745