Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa : a systematic review

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dc.contributor.authorChisompola, Namaunga Kasumuen_ZA
dc.contributor.authorStreicher, Elizabeth Mariaen_ZA
dc.contributor.authorMuchemwa, Chishala Miriam Kapambween_ZA
dc.contributor.authorWarren, Robin Marken_ZA
dc.contributor.authorSampson, Samantha Leighen_ZA
dc.date.accessioned2020-05-28T18:51:10Z
dc.date.available2020-05-28T18:51:10Z
dc.date.issued2020
dc.descriptionCITATION: Chisompola, N. K., et al. 2020. Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa : a systematic review. BMC Infectious Diseases, 20:344, doi:10.1186/s12879-020-05031-5.
dc.descriptionThe original publication is available at https://bmcinfectdis.biomedcentral.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund
dc.description.abstractBackground: The burden of drug resistant tuberculosis in Africa is largely driven by the emergence and spread of multidrug resistant (MDR) and extensively drug resistant (XDR) Mycobacterium tuberculosis strains. MDR-TB is defined as resistance to isoniazid and rifampicin, while XDR-TB is defined as MDR-TB with added resistance to any of the second line injectable drugs and any fluoroquinolone. The highest burden of drug resistant TB is seen in countries further experiencing an HIV epidemic. The molecular mechanisms of drug resistance as well as the evolution of drug resistant TB strains have been widely studied using various genotyping tools. The study aimed to analyse the drug resistant lineages in circulation and transmission dynamics of these lineages in Africa by describing outbreaks, nosocomial transmission and migration. Viewed as a whole, this can give a better insight into the transmission dynamics of drug resistant TB in Africa. Methods: A systematic review was performed on peer reviewed original research extracted from PubMed reporting on the lineages associated with drug resistant TB from African countries, and their association with outbreaks, nosocomial transmission and migration. The search terms “Tuberculosis AND drug resistance AND Africa AND (spoligotyping OR molecular epidemiology OR IS6110 OR MIRU OR DNA fingerprinting OR RFLP OR VNTR OR WGS)” were used to identify relevant articles reporting the molecular epidemiology of drug resistant TB in Africa. Results: Diverse genotypes are associated with drug resistant TB in Africa, with variations in strain predominance within the continent. Lineage 4 predominates across Africa demonstrating the ability of “modern strains” to adapt and spread easily. Most studies under review reported primary drug resistance as the predominant type of transmission. Drug resistant TB strains are associated with community and nosocomial outbreaks involving MDRand XDR-TB strains. The under-use of molecular epidemiological tools is of concern, resulting in gaps in knowledge of the transmission dynamics of drug resistant TB on the continent. Conclusions: Genetic diversity of M. tuberculosis strains has been demonstrated across Africa implying that diverse genotypes are driving the epidemiology of drug resistant TB across the continent.en_ZA
dc.description.urihttps://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-020-05031-5
dc.description.versionPublisher's version
dc.format.extent16 pages
dc.identifier.citationChisompola, N. K., et al. 2020. Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa : a systematic review. BMC Infectious Diseases, 20:344, doi:10.1186/s12879-020-05031-5
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi:10.1186/s12879-020-05031-5
dc.identifier.urihttp://hdl.handle.net/10019.1/108615
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectMycobacterium tuberculosis -- Genetic aspectsen_ZA
dc.subjectMycobacterium tuberculosis -- Molecular aspectsen_ZA
dc.subjectMolecular epidemiologyen_ZA
dc.subjectMultidrug-resistant tuberculosis -- Africaen_ZA
dc.titleMolecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa : a systematic reviewen_ZA
dc.typeArticleen_ZA
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