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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Changing Mycobacterium tuberculosis population highlights clade-specific pathogenic characteristics
Tuberculosis, Volume 89, No. 2, Year 2009
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Description
Mycobacterium tuberculosis strains can be classified into a number of major clades according to defined evolutionary markers. It is hypothesised that strains comprising these clades have evolved different properties which may influence a local strain population structure. To investigate this, we analysed the incidence of tuberculosis caused by the predominant clades (Beijing, Haarlem, LAM, Quebec and the Low-Copy Clade) found in a community within the Cape Town metropole in South Africa over a 12-year period. We found that while the incidence of cases infected with strains of the Haarlem, LAM, Quebec and the Low-Copy Clades remained relatively stable, that of cases of the Beijing clade increased exponentially over time, with a doubling time of 4.86 years (P = 0.018). This growth was exclusively attributable to drug-susceptible strains. Although drug-resistant Beijing cases remained constant in number, non-Beijing drug-resistant cases declined over time (P = 0.007). Drug-susceptible Beijing-infected cases had a greater proportion of smear-positive sputa than their non-Beijing counterparts (P = 0.013) and were less likely to be successfully treated (retreatment cases) (P = 0.026). Recent evidence suggests that these differences likely reflect enhanced pathogenicity rather than transmissibility. The rapid emergence of Beijing strains demonstrates adaptation to conditions within the study community and poses a grave challenge to future TB control. © 2008 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Van Der Spuy, Gian D.
South Africa, Tygerberg
South African Medical Research Council
Kremer, Kristin
Netherlands, Bilthoven
Rijksinstituut Voor Volksgezondheid en Milieu
Ndabambi, S. L.
South Africa, Tygerberg
South African Medical Research Council
Beyers, Nulda
South Africa, Tygerberg
Faculty of Health Sciences
Dunbar, Rory
South Africa, Tygerberg
Faculty of Health Sciences
Marais, Ben J.
South Africa, Tygerberg
Faculty of Health Sciences
Van Helden, Paul D.
South Africa, Tygerberg
South African Medical Research Council
Warren, Robin Mark
South Africa, Tygerberg
South African Medical Research Council
Statistics
Citations: 109
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1016/j.tube.2008.09.003
ISSN:
14729792
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa