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dc.contributor.authorStavrum, Ruthen_US
dc.contributor.authorPrayGod, Georgeen_US
dc.contributor.authorRange, Nyagosya S.en_US
dc.contributor.authorFaurholt-Jepsen, Danielen_US
dc.contributor.authorJeremiah, Kidolaen_US
dc.contributor.authorFaurholt-Jepsen, Mariaen_US
dc.contributor.authorKrarup, Henriken_US
dc.contributor.authorAabye, Martine G.en_US
dc.contributor.authorChangalucha, Johnen_US
dc.contributor.authorFriis, Henriken_US
dc.contributor.authorAndersen, Aase B.en_US
dc.contributor.authorGrewal, Harleen M. S.en_US
dc.date.accessioned2014-09-15T06:51:17Z
dc.date.available2014-09-15T06:51:17Z
dc.date.issued2014-06-05eng
dc.identifier.issn1471-2334
dc.identifier.urihttps://hdl.handle.net/1956/8468
dc.description.abstractBackground: There is increasing evidence to suggest that different Mycobacterium tuberculosis lineages cause variations in the clinical presentation of tuberculosis (TB). Certain M. tuberculosis genotypes/lineages have been shown to be more likely to cause active TB in human populations from a distinct genetic ancestry. This study describes the genetic biodiversity of M. tuberculosis genotypes in Mwanza city, Tanzania and the clinical presentation of the disease caused by isolates of different lineages. Methods: Two-hundred-fifty-two isolates from pulmonary TB patients in Mwanza, Tanzania were characterized by spoligotyping, and 45 isolates were further characterized by mycobacterium interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). The patients’ level of the acute phase reactants AGP, CRP and neutrophil counts, in addition to BMI, were measured and compared to the M. tuberculosis lineage of the infectious agent for each patient. Results: The most frequent genotype was ST59 (48 out of 248 [19.4%]), belonging to the Euro-American lineage LAM11_ZWE, followed by ST21 (CAS_KILI lineage [44 out of 248 [17.7%]). A low degree of diversity (15.7% [39 different ST’s out of 248 isolates]) of genotypes, in addition to a high level of mixed M. tuberculosis sub-populations among isolates with an unreported spoligotype pattern (10 out of 20 isolates [50.0%]) and isolates belonging to the ST53 lineage (13 out of 25 [52%]) was observed. Isolates of the ‘modern’ (TbD1-) Euro-American lineage induced higher levels of α1-acid glycoprotein (β = 0.4, P = 0.02; 95% CI [0.06-0.66]) and neutrophil counts (β = 0.9, P = 0.02; 95% CI [0.12-1.64]) and had lower BMI score (β = −1.0, P = 0.04; 95% CI[−1.89 – (−0.03)]). LAM11_ZWE (‘modern’) isolates induced higher levels of CRP (β = 24.4, P = 0.05; 95% CI[0.24-48.63]) and neutrophil counts (β = 0.9, P = 0.03; 95% CI[0.09-1.70]). Conclusion: The low diversity of genotypes may be explained by an evolutionary advantage of the most common lineages over other lineages combined with optimal conditions for transmission, such as overcrowding and inadequate ventilation. The induction of higher levels of acute phase reactants in patients infected by ‘modern’ lineage isolates compared to ‘ancient’ lineages may suggest increased virulence among ‘modern’ lineage isolates.en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0eng
dc.titleIncreased level of acute phase reactants in patients infected with modern Mycobacterium tuberculosis genotypes in Mwanza, Tanzaniaen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2014-08-27T11:32:33Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2014 Stavrum et al.; licensee BioMed Central Ltd.
dc.rights.holderRuth Stavrum et al.; licensee BioMed Central Ltd.
dc.source.articlenumber309
dc.identifier.doihttps://doi.org/10.1186/1471-2334-14-309
dc.identifier.cristin1161337
dc.source.journalBMC Infectious Diseases
dc.source.4014


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