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Mycobacterium africanum Is Associated with Patient Ethnicity in Ghana
Authors:Adwoa Asante-Poku  Dorothy Yeboah-Manu  Isaac Darko Otchere  Samuel Y. Aboagye  David Stucki  Jan Hattendorf  Sonia Borrell  Julia Feldmann  Emelia Danso  Sebastien Gagneux
Affiliation:1. Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.; 2. Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.; 3. University of Basel, Basel, Switzerland.; 4. Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.; University of Tennessee, United States of America,
Abstract:Mycobacterium africanum is a member of the Mycobacterium tuberculosis complex (MTBC) and an important cause of human tuberculosis in West Africa that is rarely observed elsewhere. Here we genotyped 613 MTBC clinical isolates from Ghana, and searched for associations between the different phylogenetic lineages of MTBC and patient variables. We found that 17.1% (105/613) of the MTBC isolates belonged to M. africanum, with the remaining belonging to M. tuberculosis sensu stricto. No M. bovis was identified in this sample. M. africanum was significantly more common in tuberculosis patients belonging to the Ewe ethnic group (adjusted odds ratio: 3.02; 95% confidence interval: 1.67–5.47, p<0.001). Stratifying our analysis by the two phylogenetic lineages of M. africanum (i.e. MTBC Lineages 5 and 6) revealed that this association was mainly driven by Lineage 5 (also known as M. africanum West Africa 1). Our findings suggest interactions between the genetic diversity of MTBC and human diversity, and offer a possible explanation for the geographical restriction of M. africanum to parts of West Africa.
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