DORMINANT MYCOBACTERIA IN NIGERIA

Agatha Ani1 , Torbjørn Bruvik3, John Idoko2

and Ulf, Dahle3

1. Department of Medical Microbiology 2 Department of Medicine

University of JosPMB 2084Jos, Nigeria

3. The Norwegian Institute of Public Health Oslo

NIGERIA: OVERVIEW

OVERVIEW OF TUBERCULOSIS IN NIGERIA

TB is a major cause of morbidity and mortality in Nigeria,TB incidence in Nigeria is rated at 311/100,000 with about 317/100,000 new cases (WHO, 2008). Second highest for TB disease burden in Africa (worsened by of HIV/AIDS, Ranks 5th among the 22 high TB burden countries in the world (WHO Global TB Report, 2008).Recent sentinel survey (2006), reported 30% HIV prevalence among TB casesEmergence of drug resistant M. tuberculosis presents additional burden to the control of TB.

Estimated that 1.9% of the new TB cases have MDR-TB

INTRODUCTION

The epidemiology of TB in Nigeria is poorly understood.

Low case detection rates and poor treatment outcome among others are likely to enhance TB transmission in Nigeria

Genetic methods are required for TB epidemiological studies.

Spoligotyping, a PCR based method that detects the presence or absence of a 43 spacers between short direct repeats on M. tuberculosis genome is well reported.

Spoligotyping is considered relatively less expensive and reproducible method that allows the use of computerised data base (e.g. SpolDB4). Generated data can be analysed and compared to the global M tuberculosis population

MATERIALS AND METHODS

Pulmonary isolates of M tuberculosis from children and adults in Jos, Nigeria were tested.

Isolation and drug susceptibility of M. tuberculosis (on LJ slopes) were performed at the Research Laboratory, Department of Medical Microbiology, University of Jos, Nigeria

DNA was extracted from 111 of the isolates and shipped to the Division of Infectious Disease Control, Norwegian Institute of Public Health Oslo for Spoligotyping.

Spoliopatterns were assigned to families and subfamilies using SpolDB4 Spotclust databases.

.

SPOLIGOTYPING

RESULTS (TABLE1)

Spoligotypes of M tuberculosis from TB Centres in Jos, Nigeria N(%)

Spoligo- (Family)

ABJ APIN ECWA

JUTH PH ZW Total N(%)

LAM

8 (72)

8 (80)

21 (88)

27 (69)

11 (73)

9 (75)

84 (77)

Haarlem

0 0 0 8(21) 1 1 10(9)

X3

1(9) 1(10) 2(8) 0 1(7) 1(8) 6(5)

T&F

1(9) 1(10) 1(4) 2(5) 1(7) 6(5)

EA

0 0 0 0 1(7) 1(8) 2(2)

M africanum

1(9) 0 0 0 0 0 1(1)

Untypable

0 0 0 2(5) 0 0 2(2)

Total examined

11 10 24 39 15 12 111

RESULTS FIG 1. DENDOGRAM BASED ON SPOLIGOPATTERN

Discussion

The dominance of few M. tuberculosis lineages indicate a high rate of transmission, high levels of synonymous import or a highly conserved genotype.

It remains to be confirmed whether the large cluster of identical LAM10 represent an outbreak.

Alternatively the low level of genetic variation among the non-identical isolates within this subfamily may indicate recent expansion of this group in Jos or simultaneous import from neighboring countries.

Similar patterns, yet less obvious, have been shown in other West-African countries.

Conclusion

These findings suggest a recent local expansion of M. tuberculosis in West Africa. An extended population-based study is needed to confirm the hypothesis

ACKNOWLEDGEMENT

The University of Jos, Jos, Nigeria

The Norwegian Institute of Public Health Oslo

APIN+ Jos University Hospital, Nigeria

EDCTP Forum

APPRECIATION

THANK YOU!

DORMINANT MYCOBACTERIA IN NIGERIANIGERIA: OVERVIEWOVERVIEW OF TUBERCULOSIS IN NIGERIAINTRODUCTIONMATERIALS AND METHODSSPOLIGOTYPINGRESULTS (TABLE1)RESULTS FIG 1. DENDOGRAM BASED ON SPOLIGOPATTERNDiscussion ConclusionACKNOWLEDGEMENTAPPRECIATION