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Osei-Wusu S, Tetteh JKA, Musah AB, Ntiamoah DO, Arthur N, Adjei A, Arbues A, Ofori EA, Mensah KA, Galevo SEA, Frempong AF, Asare P, Asante-Poku A, Otchere ID, Kusi KA, Lenz TL, Gagneux S, Portevin D, Yeboah-Manu D. Macrophage susceptibility to infection by Ghanaian Mycobacterium tuberculosis complex lineages 4 and 5 varies with self-reported ethnicity. Front Cell Infect Microbiol 2023; 13:1163993. [PMID: 37645380 PMCID: PMC10461633 DOI: 10.3389/fcimb.2023.1163993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Background The epidemiology of Mycobacterium tuberculosis complex (MTBC) lineage 5 (L5) infections in Ghana revealed a significantly increased prevalence in Ewes compared to other self-reported ethnic groups. In that context, we sought to investigate the early phase of tuberculosis (TB) infection using ex vivo infection of macrophages derived from the blood of Ewe and Akan ethnic group volunteers with MTBC L4 and L5 strains. Methods The study participants consisted of 16 controls, among which self-reported Akan and Ewe ethnicity was equally represented, as well as 20 cured TB cases consisting of 11 Akans and 9 Ewes. Peripheral blood mononuclear cells were isolated from both healthy controls and cured TB cases. CD14+ monocytes were isolated and differentiated into monocyte-derived macrophages (MDMs) before infection with L4 or L5 endemic strains. The bacterial load was assessed after 2 hours (uptake) as well as 3 and 7 days post-infection. Results We observed a higher capacity of MDMs from Ewes to phagocytose L4 strains (p < 0.001), translating into a higher bacillary load on day 7 (p < 0.001) compared to L5, despite the higher replication rate of L5 in Ewe MDMs (fold change: 1.4 vs. 1.2, p = 0.03) among the controls. On the contrary, within macrophages from Akans, we observed a significantly higher phagocytic uptake of L5 (p < 0.001) compared to L4, also translating into a higher load on day 7 (p = 0.04). However, the replication rate of L4 in Akan MDMs was higher than that of L5 (fold change: L4 = 1.2, L4 = 1.1, p = 0.04). Although there was no significant difference in the uptake of L4 and L5 among cured TB cases, there was a higher bacterial load of both L4 (p = 0.02) and L5 (p = 0.02) on day 7 in Ewe MDMs. Conclusion Our results suggest that host ethnicity (driven by host genetic diversity), MTBC genetic diversity, and individual TB infection history are all acting together to modulate the outcome of macrophage infections by MTBC.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - John K. A. Tetteh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | | | - Nelly Arthur
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Abraham Adjei
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Ainhoa Arbues
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ebenezer Addo Ofori
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Akyea Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | | | - Abena Frema Frempong
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Asamoah Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Tobias L. Lenz
- Research Group for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Damien Portevin
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Zwyer M, Rutaihwa LK, Windels E, Hella J, Menardo F, Sasamalo M, Sommer G, Schmülling L, Borrell S, Reinhard M, Dötsch A, Hiza H, Stritt C, Sikalengo G, Fenner L, De Jong BC, Kato-Maeda M, Jugheli L, Ernst JD, Niemann S, Jeljeli L, Ballif M, Egger M, Rakotosamimanana N, Yeboah-Manu D, Asare P, Malla B, Dou HY, Zetola N, Wilkinson RJ, Cox H, Carter EJ, Gnokoro J, Yotebieng M, Gotuzzo E, Abimiku A, Avihingsanon A, Xu ZM, Fellay J, Portevin D, Reither K, Stadler T, Gagneux S, Brites D. Back-to-Africa introductions of Mycobacterium tuberculosis as the main cause of tuberculosis in Dar es Salaam, Tanzania. PLoS Pathog 2023; 19:e1010893. [PMID: 37014917 PMCID: PMC10104295 DOI: 10.1371/journal.ppat.1010893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 04/14/2023] [Accepted: 03/01/2023] [Indexed: 04/05/2023] Open
Abstract
In settings with high tuberculosis (TB) endemicity, distinct genotypes of the Mycobacterium tuberculosis complex (MTBC) often differ in prevalence. However, the factors leading to these differences remain poorly understood. Here we studied the MTBC population in Dar es Salaam, Tanzania over a six-year period, using 1,082 unique patient-derived MTBC whole-genome sequences (WGS) and associated clinical data. We show that the TB epidemic in Dar es Salaam is dominated by multiple MTBC genotypes introduced to Tanzania from different parts of the world during the last 300 years. The most common MTBC genotypes deriving from these introductions exhibited differences in transmission rates and in the duration of the infectious period, but little differences in overall fitness, as measured by the effective reproductive number. Moreover, measures of disease severity and bacterial load indicated no differences in virulence between these genotypes during active TB. Instead, the combination of an early introduction and a high transmission rate accounted for the high prevalence of L3.1.1, the most dominant MTBC genotype in this setting. Yet, a longer co-existence with the host population did not always result in a higher transmission rate, suggesting that distinct life-history traits have evolved in the different MTBC genotypes. Taken together, our results point to bacterial factors as important determinants of the TB epidemic in Dar es Salaam.
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Affiliation(s)
- Michaela Zwyer
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Liliana K Rutaihwa
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Etthel Windels
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Jerry Hella
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Fabrizio Menardo
- Department of Plant and Microbial Biology, University of Zürich, Zürich, Switzerland
| | - Mohamed Sasamalo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Gregor Sommer
- Institut für Radiologie und Nuklearmedizin, Hirslanden Klinik St. Anna, Luzern, Switzerland
| | - Lena Schmülling
- Klinik für Radiologie und Nuklearmedizin, Department Theragnostik, Universitätsspital Basel, Basel, Switzerland
| | - Sonia Borrell
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Dötsch
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Hellen Hiza
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Christoph Stritt
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - George Sikalengo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- St. Francis Referral Hospital, Ifakara, Tanzania
| | - Lukas Fenner
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Bouke C De Jong
- Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Midori Kato-Maeda
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, California, United States of America
| | - Levan Jugheli
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Joel D Ernst
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, California, United States
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Borstel Research Centre, Borstel, Germany
| | - Leila Jeljeli
- Molecular and Experimental Mycobacteriology, Borstel Research Centre, Borstel, Germany
| | - Marie Ballif
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Research and Epidemiology, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Bijaya Malla
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Horng Yunn Dou
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institute, Zhunan, Taiwan
| | - Nicolas Zetola
- Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Robert J Wilkinson
- Wellcome Center for Infectious Diseases Research in Africa, Cape Town, South Africa
- Francis Crick Institute, London, United Kingdom
| | - Helen Cox
- Institute of Infectious Diseases and Molecular Medicine and the Wellcome Centre for Infectious Disease Research in Africa, University of Cape Town, Cape Town, South Africa
| | - E Jane Carter
- Division of Pulmonary and Critical Care Medicine, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, United States of America
| | - Joachim Gnokoro
- Centre de Prise en Charge de Recherche et de Formation, Abidjan, Côte d'Ivoire
| | - Marcel Yotebieng
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross AIDS Research Centre and Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Zhi Ming Xu
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jacques Fellay
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Damien Portevin
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Klaus Reither
- University of Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniela Brites
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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3
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Adu B, Bonney JH, Egyir B, Otchere ID, Asare P, Dennis FE, Bonney EY, Akuffo R, Asante IA, Obodai E, Kumordjie S, Appiah-Kubi J, Mohktar Q, Frempong HO, Asiedu-Bekoe F, Adusei-Poku MA, Aboagye JO, Agbodzi B, Yeboah C, Agbenyo SB, Uche PO, Attiku KO, Sekyere BT, Laryea D, Buabeng K, Lamptey H, Ghansah A, Yeboah-Manu D, Anang AK, Ampofo WK, Kyei GB, Odoom JK. SARS-CoV-2 Molecular Evolutionary Dynamics in the Greater Accra Region, Ghana. Emerg Infect Dis 2023; 29:862-865. [PMID: 36958011 PMCID: PMC10045712 DOI: 10.3201/eid2904.221410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
To assess dynamics of SARS-CoV-2 in Greater Accra Region, Ghana, we analyzed SARS-CoV-2 genomic sequences from persons in the community and returning from international travel. The Accra Metropolitan District was a major origin of virus spread to other districts and should be a primary focus for interventions against future infectious disease outbreaks.
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Affiliation(s)
| | | | - Beverly Egyir
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Francis E. Dennis
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evelyn Yayra Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Ivy A. Asante
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evangeline Obodai
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Selassie Kumordjie
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Joyce Appiah-Kubi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Quaneeta Mohktar
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Hilda Opoku Frempong
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Franklin Asiedu-Bekoe
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Mildred A. Adusei-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - James O. Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bright Agbodzi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Clara Yeboah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Seyram B. Agbenyo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Peace O. Uche
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Keren O. Attiku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bernice Twenewaa Sekyere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dennis Laryea
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Kwame Buabeng
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Helena Lamptey
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Anita Ghansah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Abraham K. Anang
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - William K. Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - George B. Kyei
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - John K. Odoom
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
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Otchere ID, Morgan PA, Asare P, Osei-Wusu S, Aboagye SY, Yirenkyi SO, Musah AB, Danso EK, Tetteh-Ocloo G, Afum T, Asante-Poku A, Laryea C, Poku YA, Bonsu F, Gagneux S, Yeboah-Manu D. Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases. Front Microbiol 2023; 13:1069292. [PMID: 36713197 PMCID: PMC9878308 DOI: 10.3389/fmicb.2022.1069292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. Methods Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. Results A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANYr); 16.8% (50/298) were isoniazid-mono-resistant (INHr), 16.8% (50/298) were rifampicin-mono-resistant (RIFr), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANYr were additionally resistant to at least one second line drug: 7.4% (2 RIFr, 1 INHr, and 10 MDR samples) resistant to only FQs and 2.3% (2 RIFr, 1 INHr, and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIFr and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INHr and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. Conclusion The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Portia Abena Morgan
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Institute for Environment and Sanitation Studies, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Theophilus Afum
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Yaw Adusi Poku
- National Tuberculosis Control Program, Ghana Health Service, Accra, Ghana
| | - Frank Bonsu
- National Tuberculosis Control Program, Ghana Health Service, Accra, Ghana
| | - Sebastien Gagneux
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
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5
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Acquah SEK, Asare P, Danso EK, Tetteh P, Tetteh AY, Boateng D, Osei-Wusu S, Afum T, Ayamdooh YI, Akugre EA, Samad OA, Quaye L, Obiri-Danso K, Kock R, Asante-Poku A, Yeboah-Manu D. Molecular epidemiology of bovine tuberculosis in Northern Ghana identifies several uncharacterized bovine spoligotypes and suggests possible zoonotic transmission. PLoS Negl Trop Dis 2022; 16:e0010649. [PMID: 35951638 PMCID: PMC9398027 DOI: 10.1371/journal.pntd.0010649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/23/2022] [Accepted: 07/09/2022] [Indexed: 11/18/2022] Open
Abstract
Objective
We conducted an abattoir-based cross-sectional study in the five administrative regions of Northern Ghana to determine the distribution of bovine tuberculosis (BTB) among slaughtered carcasses and identify the possibility of zoonotic transmission.
Methods
Direct smear microscopy was done on 438 tuberculosis-like lesions from selected cattle organs and cultured on Lowenstein-Jensen media. Acid-fast bacilli (AFB) isolates were confirmed as members of the Mycobacterium tuberculosis complex (MTBC) by PCR amplification of IS6110 and rpoß. Characterization and assignment into MTBC lineage and sub-lineage were done by spoligotyping, with the aid of the SITVIT2, miruvntrplus and mbovis.org databases. Spoligotype data was compared to that of clinical M. bovis isolates from the same regions to identify similarities.
Results
A total of 319/438 (72.8%) lesion homogenates were smear positive out of which, 84.6% (270/319) had microscopic grade of at least 1+ for AFB. Two hundred and sixty-five samples (265/438; 60.5%) were culture positive, of which 212 (80.0%) were MTBC. Approximately 16.7% (34/203) of the isolates with correctly defined spoligotypes were negative for IS6110 PCR but were confirmed by rpoß. Spoligotyping characterized 203 isolates as M. bovis (198, 97.5%), M. caprae (3, 1.5%), M. tuberculosis (Mtbss) lineage (L) 4 Cameroon sub-lineage, (1, 0.5%), and M. africanum (Maf) L6 (1, 0.5%). A total of 53 unique spoligotype patterns were identified across the five administrative regions (33 and 28 were identified as orphan respectively by the SITVIT2 and mbovis.org databases), with the most dominant spoligotype being SIT1037/ SB0944 (77/203, 37.93%). Analysis of the bovine and human M. bovis isolates showed 75% (3/4) human M. bovis isolates sharing the same spoligotype pattern with the bovine isolates.
Conclusion
Our study identified that approximately 29% of M. bovis strains causing BTB in Northern Ghana are caused by uncharacterized spoligotypes. Our findings suggest possible zoonotic transmission and highlight the need for BTB disease control in Northern Ghana.
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Affiliation(s)
- Samuel Ekuban Kobina Acquah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Clinical Microbiology, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail: (PA); (DYM)
| | - Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Phillip Tetteh
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Amanda Yaa Tetteh
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Daniel Boateng
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Theophilus Afum
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Eric Agongo Akugre
- Veterinary Services Directorate, Ministry of Food and Agriculture, Bolgatanga, Ghana
| | - Omar Abdul Samad
- Veterinary Services Directorate, Ministry of Food and Agriculture, Wa, Ghana
| | - Lawrence Quaye
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Kwasi Obiri-Danso
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Kock
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail: (PA); (DYM)
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Afum T, Asandem DA, Asare P, Asante-Poku A, Mensah GI, Musah AB, Opare D, Taniguchi K, Guinko NM, Aphour T, Arhin D, Ishikawa K, Matano T, Mizutani T, Asiedu-Bekoe F, Kiyono H, Anang AK, Koram KA, Yeboah-Manu D. Diarrhea-Causing Bacteria and Their Antibiotic Resistance Patterns Among Diarrhea Patients From Ghana. Front Microbiol 2022; 13:894319. [PMID: 35663873 PMCID: PMC9161929 DOI: 10.3389/fmicb.2022.894319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Diarrheal disease remains a major global health problem particularly in children under 5 years and the emergence of antibiotic-resistant strains of causative pathogens could slow control efforts, particularly in settings where treatment options are limited. This surveillance study conducted in Ghana aimed to determine the prevalence and antimicrobial susceptibility profile of diarrhea-causing bacteria. This was a cross-sectional study carried out in five health facilities in the Ga West Municipality of Ghana between 2017 and 2021. Diarrheic stool samples from patients were collected and cultured on standard differential/selective media and isolates identified by standard biochemical tests, MALDI-TOF assay, and serological analysis. The antibiogram was determined using Kirby-Bauer disk diffusion and Microscan autoScan4 MIC panels which were used for extended-spectrum beta-lactamase (ESBL) detection. Bacteria were isolated from 97.5% (772/792) of stool samples, and 167 of the isolates were diarrheagenic and met our inclusion criteria for antimicrobial resistance (AMR) analysis. These included Escherichia coli (49.1%, 82/167), Salmonella species (23.9%, 40/167), Vibrio species (16.8%, 28/167), and Shigella species (10.2%, 17/167). Among 24 Vibrio species, we observed resistances to cefotaxime (21/24, 87.5%), ceftriaxone (20/24, 83.3%), and ciprofloxacin (6/24, 25%), including four multi-drug resistant isolates. All 13 Vibrio parahaemolyticus isolates were resistant to cefazolin. All 17 Shigella isolates were resistant to tetracycline with resistance to shigellosis drugs such as norfloxacin and ciprofloxacin. Salmonella isolates were highly susceptible to norfloxacin (40/40, 100%) and tetracycline (12/34, 35%). Two ESBL-producing E. coli were also identified with marked susceptibility to gentamicin (66/72, 91.7%) and amikacin (57/72, 79.2%) prescribed in the treatment of E. coli infections. This study showed the different bacteria implicated in diarrhea cases in Ghana and the need for differential diagnoses for better treatment outcomes. Escherichia coli, Shigella, Salmonella, and Vibrio have all been implicated in diarrhea cases in Ghana. The highest prevalence was E. coli and Salmonella with Shigella the least prevalent. Resistance to commonly used drugs found in these isolates may render bacteria infection treatment in the near future nearly impossible. Routine antimicrobial susceptibility testing, effective monitoring, and nationwide surveillance of AMR pathogens should be implemented to curb the increase of antimicrobial resistance in Ghana.
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Affiliation(s)
- Theophilus Afum
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Diana Asema Asandem
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gloria Ivy Mensah
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Abdul Basit Musah
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Kiyosi Taniguchi
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Graduate School of Medicine, Institute for Global Prominent Research, Chiba University, Chiba, Japan
| | | | | | | | - Koichi Ishikawa
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Tetsuro Matano
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | | | | | - Hiroshi Kiyono
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Graduate School of Medicine, Institute for Global Prominent Research, Chiba University, Chiba, Japan
- Department of Medicine, CU-UCSD Center for Mucosal Immunology, Allergy and Vaccines (cMAV), University of California San Diego, San Diego, CA, United States
| | - Abraham Kwabena Anang
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kwadwo Ansah Koram
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- *Correspondence: Dorothy Yeboah-Manu,
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Asante-Poku A, Morgan P, Osei-Wusu S, Aboagye SY, Asare P, Otchere ID, Adadey SM, Mnika K, Esoh K, Mawuta KH, Arthur N, Forson A, Mazandu GK, Wonkam A, Yeboah-Manu D. Genetic Analysis of TB Susceptibility Variants in Ghana Reveals Candidate Protective Loci in SORBS2 and SCL11A1 Genes. Front Genet 2022; 12:729737. [PMID: 35242163 PMCID: PMC8886735 DOI: 10.3389/fgene.2021.729737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/08/2021] [Indexed: 12/31/2022] Open
Abstract
Despite advancements made toward diagnostics, tuberculosis caused by Mycobacterium africanum (Maf) and Mycobacterium tuberculosis sensu stricto (Mtbss) remains a major public health issue. Human host factors are key players in tuberculosis (TB) outcomes and treatment. Research is required to probe the interplay between host and bacterial genomes. Here, we explored the association between selected human/host genomic variants and TB disease in Ghana. Paired host genotype datum and infecting bacterial isolate information were analyzed for associations using a multinomial logistic regression. Mycobacterium tuberculosis complex (MTBC) isolates were obtained from 191 TB patients and genotyped into different phylogenetic lineages by standard methods. Two hundred and thirty-five (235) nondisease participants were used as healthy controls. A selection of 29 SNPs from TB disease-associated genes with high frequency among African populations was assayed using a TaqMan® SNP Genotyping Assay and iPLEX Gold Sequenom Mass Genotyping Array. Using 26 high-quality SNPs across 326 case-control samples in an association analysis, we found a protective variant, rs955263, in the SORBS2 gene against both Maf and Mtb infections (PBH = 0.05; OR = 0.33; 95% CI = 0.32–0.34). A relatively uncommon variant, rs17235409 in the SLC11A1 gene was observed with an even stronger protective effect against Mtb infection (MAF = 0.06; PBH = 0.04; OR = 0.05; 95% CI = 0.04–0.05). These findings suggest SLC11A1 and SORBS2 as a potential protective gene of substantial interest for TB, which is an important pathogen in West Africa, and highlight the need for in-depth host-pathogen studies in West Africa.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
- *Correspondence: Adwoa Asante-Poku,
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Samuel Mawuli Adadey
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Khuthala Mnika
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kevin Esoh
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kenneth Hayibor Mawuta
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Nelly Arthur
- Department of Chest Diseases, Korle-Bu Teaching Hospital Korle-Bu, Accra, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital Korle-Bu, Accra, Ghana
| | - Gaston Kuzamunu Mazandu
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
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8
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Afum T, Asare P, Asante-Poku A, Darko-Otchere I, Morgan PA, Bedeley E, Asandem DA, Musah AB, Siam IM, Tetteh P, Adusi-Poku Y, Frimpong-Manso R, Bonney JHK, Ampofo W, Yeboah-Manu D. Diagnosis of tuberculosis among COVID-19 suspected cases in Ghana. PLoS One 2021; 16:e0261849. [PMID: 34962960 PMCID: PMC8714104 DOI: 10.1371/journal.pone.0261849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background Tuberculosis (TB) and COVID-19 pandemics are both diseases of public health threat globally. Both diseases are caused by pathogens that infect mainly the respiratory system, and are involved in airborne transmission; they also share some clinical signs and symptoms. We, therefore, took advantage of collected sputum samples at the early stage of COVID-19 outbreak in Ghana to conduct differential diagnoses of long-standing endemic respiratory illness, particularly tuberculosis. Methodology Sputum samples collected through the enhanced national surveys from suspected COVID-19 patients and contact tracing cases were analyzed for TB. The sputum samples were processed using Cepheid’s GeneXpert MTB/RIF assay in pools of 4 samples to determine the presence of Mycobacterium tuberculosis complex. Positive pools were then decoupled and analyzed individually. Details of positive TB samples were forwarded to the NTP for appropriate case management. Results Seven-hundred and seventy-four sputum samples were analyzed for Mycobacterium tuberculosis in both suspected COVID-19 cases (679/774, 87.7%) and their contacts (95/774, 12.3%). A total of 111 (14.3%) were diagnosed with SARS CoV-2 infection and six (0.8%) out of the 774 individuals tested positive for pulmonary tuberculosis: five (83.3%) males and one female (16.7%). Drug susceptibility analysis identified 1 (16.7%) rifampicin-resistant tuberculosis case. Out of the six TB positive cases, 2 (33.3%) tested positive for COVID-19 indicating a coinfection. Stratifying by demography, three out of the six (50%) were from the Ayawaso West District. All positive cases received appropriate treatment at the respective sub-district according to the national guidelines. Conclusion Our findings highlight the need for differential diagnosis among COVID-19 suspected cases and regular active TB surveillance in TB endemic settings.
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Affiliation(s)
- Theophilus Afum
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail: (DYM); (PA)
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko-Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Portia Abena Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edmund Bedeley
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Diana Asema Asandem
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ishaque Mintah Siam
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Phillip Tetteh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Yaw Adusi-Poku
- National Tuberculosis Control Programme, Ghana Health Service, Accra, Ghana
| | | | | | - William Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail: (DYM); (PA)
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Osei-Wusu S, Morgan P, Asare P, Adams G, Musah AB, Siam IM, Gillespie SH, Sabiiti W, Yeboah-Manu D. Bacterial Load Comparison of the Three Main Lineages of Mycobacterium tuberculosis Complex in West Africa. Front Microbiol 2021; 12:719531. [PMID: 34777274 PMCID: PMC8578714 DOI: 10.3389/fmicb.2021.719531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Studies have shown an association between bacterial load and virulence; however, not much is known about the diversity in this phenotypic characteristic of Mycobacterium tuberculosis complex (MTBC). This study was therefore aimed to determine the differences in bacterial load of the three most prevalent MTBC genotypes (L4, L5, and L6) in West Africa at the time of diagnosis. A total of 170 paired fresh sputum samples were collected; one part in guanidinium thiocyanate (GTC) was used for RNA extraction and tuberculosis molecular bacterial load assay (TB-MBLA), and the other part without GTC was confirmed for TB positivity using GeneXpert MTB/RIF, smear microscopy grading, and culture on Löwenstein-Jensen media slants. The 170 sputum samples comprised 155 new cases, three follow-up cases, and 12 TB negative sputum samples. The time-to-culture positivity (TTP) and degree of culture positivity (DCP) were recorded. All 122 isolates obtained were spoligotyped for lineage (L) classification, but spoligotypes were obtained from 120 isolates. Of the typed isolates, 70.0, 10.8, 10.8, 4.2, 2.5, 0.8, and 0.8% were lineages 4, 5, 6, 2, 3, 1, and Mycobacterium bovis, respectively. Further analysis of the three most prevalent lineages showed significantly shorter TTP and higher DCP by L4 compared to L5 and L6, respectively: TTP 20.8, vs. 26.5, and 28.2 days; p-value = 0.005 and DCP 1.27, vs. 0.81 and 0.29, p < 0.001. The average TB-MBLA measured bacterial load of L4 was 3.82 Log10eCFU/ml which was not significantly different from 3.81 and 3.80 Log10eCFU/ml of L5 and L6, respectively, p = 0.84. Degrees of smear microscopy L4 = 1.20, L5 = 1.20, and L6 = 0.92 and GeneXpert Cq values L4 = 17.08, L5 = 18.37, and L6 = 17.59 showed no significant difference between the lineages, p = 0.72 and p = 0.48, respectively. Retrospective analysis of a larger sample confirmed the difference in TTP, p < 0.001. In conclusion, the observed shorter TTP and high DCP of L4 could signify high growth rate in culture that is independent of total bacterial load at diagnosis.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Godfrey Adams
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ishaque Mintah Siam
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Stephen Henry Gillespie
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Wilber Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
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Thumamo Pokam BD, Yeboah-Manu D, Amiteye D, Asare P, Guemdjom PW, Yhiler NY, Azumah Morton SN, Ofori-Yirenkyi S, Laryea R, Tagoe R, Asuquo AE. Molecular epidemiology and multidrug resistance of Mycobacterium tuberculosis complex from pulmonary tuberculosis patients in the Eastern region of Ghana. Heliyon 2021; 7:e08152. [PMID: 34746460 PMCID: PMC8551511 DOI: 10.1016/j.heliyon.2021.e08152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/12/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Tuberculosis (TB) and drug-resistant TB (DR-TB) continue to persist as a serious public health challenges in Ghana. Although several research has evaluated the drug resistance of Mycobacterium tuberculosis complex (MTBc) strains across the country, there is a paucity of data on its magnitude as well as the various lineages circulating in the Eastern region of Ghana. Objective This study therefore evaluated the distribution of the various lineages of MTBc in the Eastern region of the country and the associated drug resistance. Materials and methods One hundred and forty-three (143) patients with pulmonary TB attending the Eastern Regional Hospital, Koforidua/Ghana were included in the study. The BACTEC MGIT 960 tube media was used for both sputum culture and drug susceptibility of streptomycin (STR), isoniazid (INH), rifampicin (RIF) and Ethambutol (ETH). Isolates were initially typed using IS6110, followed by large sequence polymorphisms analysis and spoligotyping. Results The majority [108 (75.5%)] of the 143 patients were male gender and the 45-54 years [46 (32.2%)] age range had the highest frequency. Forty-one (28.7%) of the 143 isolates were IS6110 negative. Of the 102 spoligotyped isolates, the main sub-lineages included 45 (44.1%) Cameroon and 23 (22.5%) Ghana. SITs 61 and 53 represented the major cluster with 22/102 (21.6%) and 13/102 (12.7%) isolates respectively, while 59/65 (90.8%) isolates belonged to Lineage 4 with 27/65 (41.5%) LAM10_CAM. MDR-TB occurred in 26/79 (32.9%) isolates, and was not associated with neither gender [20/58 (34.5%) male vs 6/21 (28.6%) female, OR = 1.31; 95%CI, 0.44-3.92; p = 0.624)] nor age. No association was found between MDR-TB and the major sub-lineages [8/25 (32%) Cameroon (OR = 0.94; 95%CI, 0.34-2.59; p = 0.920) and 5/11 (45.5%) Ghana (OR = 1.87; 95%CI, 0.51-6.80; p = 0.489)], or previously treated [8/23 (34.8%), OR = 0.89; 95%CI, 0.32-2.48; p = 0.823)] patients. Conclusion Despite the serious threat posed by MDR in the study area, no sub-lineage was shown to be associated with drug resistance. Nonetheless, a sustained surveillance of drug resistance pattern is advocated. A lower proportion of M. africanum was observed in the Eastern region of Ghana and will require further evaluation.
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Affiliation(s)
- Benjamin D Thumamo Pokam
- Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Daniel Amiteye
- Department of Biomedical Engineering, All Nations University College, Koforidua, Ghana
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Prisca Wabo Guemdjom
- Department of Public Health, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Nchawa Yangkam Yhiler
- Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Department of Allied Health, Biaka University Institute, Buea, Cameroon
| | | | | | | | | | - Anne Ebri Asuquo
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, College of Medicine, University of Calabar, Calabar, Nigeria
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Osei-Wusu S, Otchere ID, Morgan P, Musah AB, Siam IM, Asandem D, Afum T, Asare P, Asante-Poku A, Kusi KA, Gagneux S, Yeboah-Manu D. Genotypic and phenotypic diversity of Mycobacterium tuberculosis complex genotypes prevalent in West Africa. PLoS One 2021; 16:e0255433. [PMID: 34437584 PMCID: PMC8389432 DOI: 10.1371/journal.pone.0255433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022] Open
Abstract
Findings from previous comparative genomics studies of the Mycobacterium tuberculosis complex (MTBC) suggest genomic variation among the genotypes may have phenotypic implications. We investigated the diversity in the phenotypic profiles of the main prevalent MTBC genotypes in West Africa. Thirty-six whole genome sequenced drug susceptible MTBC isolates belonging to lineages 4, 5 and 6 were included in this study. The isolates were phenotypically characterized for urease activity, tween hydrolysis, Thiophen-2-Carboxylic Acid Hydrazide (TCH) susceptibility, nitric oxide production, and growth rate in both liquid (7H9) and solid media (7H11 and Löwenstein–Jensen (L-J)). Lineage 4 isolates showed the highest growth rate in both liquid (p = 0.0003) and on solid (L-J) media supplemented with glycerol (p<0.001) or pyruvate (p = 0.005). L6 isolates optimally utilized pyruvate compared to glycerol (p<0.001), whereas L5 isolates grew similarly on both media (p = 0.05). Lineage 4 isolates showed the lowest average time to positivity (TTP) (p = 0.01; Average TTP: L4 = 15days, L5 = 16.7days, L6 = 29.7days) and the highest logCFU/mL (p = 0.04; average logCFU/mL L4 = 5.9, L5 = 5.0, L6 = 4.4) on 7H11 supplemented with glycerol, but there was no significant difference in growth on 7H11 supplemented with pyruvate (p = 0.23). The highest release of nitrite was recorded for L5 isolates, followed by L4 and L6 isolates. However, the reverse was observed in the urease activity for the lineages. All isolates tested were resistant to TCH except for one L6 isolate. Comparative genomic analyses revealed several mutations that might explain the diverse phenotypic profiles of these isolates. Our findings showed significant phenotypic diversity among the MTBC lineages used for this study.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Ishaque Mintah Siam
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Diana Asandem
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Theophilus Afum
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Asamoah Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
- * E-mail:
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12
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Asare P, Asante-Poku A, Osei-Wusu S, Otchere ID, Yeboah-Manu D. The Relevance of Genomic Epidemiology for Control of Tuberculosis in West Africa. Front Public Health 2021; 9:706651. [PMID: 34368069 PMCID: PMC8342769 DOI: 10.3389/fpubh.2021.706651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/29/2021] [Indexed: 12/30/2022] Open
Abstract
Tuberculosis (TB), an airborne infectious disease caused by Mycobacterium tuberculosis complex (MTBC), remains a global health problem. West Africa has a unique epidemiology of TB that is characterized by medium- to high-prevalence. Moreover, the geographical restriction of M. africanum to the sub-region makes West Africa have an extra burden to deal with a two-in-one pathogen. The region is also burdened with low case detection, late reporting, poor treatment adherence leading to development of drug resistance and relapse. Sporadic studies conducted within the subregion report higher burden of drug resistant TB (DRTB) than previously thought. The need for more sensitive and robust tools for routine surveillance as well as to understand the mechanisms of DRTB and transmission dynamics for the design of effective control tools, cannot be overemphasized. The advancement in molecular biology tools including traditional fingerprinting and next generation sequencing (NGS) technologies offer reliable tools for genomic epidemiology. Genomic epidemiology provides in-depth insight of the nature of pathogens, circulating strains and their spread as well as prompt detection of the emergence of new strains. It also offers the opportunity to monitor treatment and evaluate interventions. Furthermore, genomic epidemiology can be used to understand potential emergence and spread of drug resistant strains and resistance mechanisms allowing the design of simple but rapid tools. In this review, we will describe the local epidemiology of MTBC, highlight past and current investigations toward understanding their biology and spread as well as discuss the relevance of genomic epidemiology studies to TB control in West Africa.
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Affiliation(s)
- Prince Asare
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Ameke S, Asare P, Aboagye SY, Otchere ID, Osei-Wusu S, Yeboah-Manu D, Asante-Poku A. Molecular epidemiology of Mycobacterium tuberculosis complex in the Volta Region of Ghana. PLoS One 2021; 16:e0238898. [PMID: 33730036 PMCID: PMC7968653 DOI: 10.1371/journal.pone.0238898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/27/2021] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Available molecular epidemiological data from recent studies suggest significant genetic variation between the different lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populations. AIM This study sought to determine the population structure of clinical MTBC isolates from the Volta Region of Ghana. METHODS The MTBC isolates obtained from collected sputum samples were identified by PCR detecting of IS6110 and genotyped using spoligotyping. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplus. RESULTS One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for MAF lineages. Spoligotyping identified 89 (76%) Lineage 4, 16 (13.6%) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.7%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two (2.2%) were orphan. Significant localization of MAF was found within the Ho municipality (n = 13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n = 3, 8.3%) (p-value = 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1). CONCLUSION We confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.
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Affiliation(s)
- Selassie Ameke
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
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Asare P, Osei-Wusu S, Baddoo NA, Bedeley E, Otchere ID, Brites D, Loiseau C, Asante-Poku A, Prah DA, Borrell S, Reinhard M, Omari MA, Forson A, Koram KA, Gagneux S, Yeboah-Manu D. Genomic epidemiological analysis identifies high relapse among individuals with recurring tuberculosis and provides evidence of recent household-related transmission of tuberculosis in Ghana. Int J Infect Dis 2021; 106:13-22. [PMID: 33667696 PMCID: PMC8134059 DOI: 10.1016/j.ijid.2021.02.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022] Open
Abstract
Unresolved previous infection as major cause of recurring tuberculosis (TB) in Ghana. Genomic epidemiology identifies high relapse among recurrent TB cases in Ghana. 15-locus MIRU-VNTR typing is sufficient to predict the cause of TB recurrence. Evidence of recent household-related TB transmission in Ghana. Need for increased education by national TB control program.
Objective To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana; West African Centre for Cell Biology of Infectious Pathogens, UG, Ghana; Department of Biochemistry, Cell and Molecular Biology, UG, Ghana.
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | | | - Edmund Bedeley
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Michael Amo Omari
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana; West African Centre for Cell Biology of Infectious Pathogens, UG, Ghana
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Coscolla M, Gagneux S, Menardo F, Loiseau C, Ruiz-Rodriguez P, Borrell S, Otchere ID, Asante-Poku A, Asare P, Sánchez-Busó L, Gehre F, Sanoussi CN, Antonio M, Affolabi D, Fyfe J, Beckert P, Niemann S, Alabi AS, Grobusch MP, Kobbe R, Parkhill J, Beisel C, Fenner L, Böttger EC, Meehan CJ, Harris SR, de Jong BC, Yeboah-Manu D, Brites D. Phylogenomics of Mycobacterium africanum reveals a new lineage and a complex evolutionary history. Microb Genom 2021; 7:000477. [PMID: 33555243 PMCID: PMC8208692 DOI: 10.1099/mgen.0.000477] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
Human tuberculosis (TB) is caused by members of the Mycobacterium tuberculosis complex (MTBC). The MTBC comprises several human-adapted lineages known as M. tuberculosis sensu stricto, as well as two lineages (L5 and L6) traditionally referred to as Mycobacterium africanum. Strains of L5 and L6 are largely limited to West Africa for reasons unknown, and little is known of their genomic diversity, phylogeography and evolution. Here, we analysed the genomes of 350 L5 and 320 L6 strains, isolated from patients from 21 African countries, plus 5 related genomes that had not been classified into any of the known MTBC lineages. Our population genomic and phylogeographical analyses showed that the unclassified genomes belonged to a new group that we propose to name MTBC lineage 9 (L9). While the most likely ancestral distribution of L9 was predicted to be East Africa, the most likely ancestral distribution for both L5 and L6 was the Eastern part of West Africa. Moreover, we found important differences between L5 and L6 strains with respect to their phylogeographical substructure and genetic diversity. Finally, we could not confirm the previous association of drug-resistance markers with lineage and sublineages. Instead, our results indicate that the association of drug resistance with lineage is most likely driven by sample bias or geography. In conclusion, our study sheds new light onto the genomic diversity and evolutionary history of M. africanum, and highlights the need to consider the particularities of each MTBC lineage for understanding the ecology and epidemiology of TB in Africa and globally.
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Affiliation(s)
- Mireia Coscolla
- ISysBio, University of Valencia-FISABIO Joint Unit, Valencia, Spain
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Menardo
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Leonor Sánchez-Busó
- Centre for Genomic Pathogen Surveillance, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Florian Gehre
- Infectious Disease Epidemiology Department, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
- Health Department, East African Community (EAC), Arusha, Tanzania
| | - C. N’Dira Sanoussi
- Laboratoire de Référence des Mycobactéries, Ministry of Health, Cotonou, Bénin
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Martin Antonio
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dissou Affolabi
- Laboratoire de Référence des Mycobactéries, Ministry of Health, Cotonou, Bénin
| | - Janet Fyfe
- Mycobacterium Reference Laboratory, Victoria Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Patrick Beckert
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- Partner Site Hamburg-Lübeck-Borstel-Riems, German Center for Infection Research, Borstel, Germany
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- Partner Site Hamburg-Lübeck-Borstel-Riems, German Center for Infection Research, Borstel, Germany
| | - Abraham S. Alabi
- Centre de Recherches Médicales en Lambaréné (Cermel), Lambaréné, Gabon
| | - Martin P. Grobusch
- Centre de Recherches Médicales en Lambaréné (Cermel), Lambaréné, Gabon
- Institut für Tropenmedizin, Deutsches Zentrum fuer Infektionsforschung, University of Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Robin Kobbe
- First Department of Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Germany
| | - Julian Parkhill
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, UK
| | - Christian Beisel
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Erik C. Böttger
- Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland
| | - Conor J. Meehan
- School of Chemistry and Biosciences, University of Bradford, Bradford, UK
| | - Simon R. Harris
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Microbiotica Limited, Bioinnovation Centre, Wellcome Genome Campus, Cambridge, CB10 1DR, UK
| | - Bouke C. de Jong
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Danso EK, Asare P, Otchere ID, Akyeh LM, Asante-Poku A, Aboagye SY, Osei-Wusu S, Opare D, Ntoumi F, Zumla A, Duodu S, Yeboah-Manu D. A molecular and epidemiological study of Vibrio cholerae isolates from cholera outbreaks in southern Ghana. PLoS One 2020; 15:e0236016. [PMID: 32649692 PMCID: PMC7351161 DOI: 10.1371/journal.pone.0236016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/27/2020] [Indexed: 11/18/2022] Open
Abstract
Cholera remains a major global public health threat and continuous emergence of new Vibrio cholerae strains is of major concern. We conducted a molecular epidemiological study to detect virulence markers and antimicrobial resistance patterns of V. cholerae isolates obtained from the 2012–2015 cholera outbreaks in Ghana. Archived clinical isolates obtained from the 2012, 2014 and 2015 cholera outbreaks in Ghana were revived by culture and subjected to microscopy, biochemical identification, serotyping, antibiotic susceptibility testing, molecular detection of distinct virulence factors and Multi-Locus Variable-Number of Tandem-Repeat Analysis (MLVA). Of 277 isolates analysed, 168 (60.6%) were confirmed to be V. cholerae and 109 (39.4%) isolates constituted other bacteria (Escherichia coli, Aeromonas sobria, Pseudomonas aeruginosa, Enterobacter cloacae and Enterococci faecalis). Serotyping the V. cholerae isolates identified 151 (89.9%) as Ogawa, 3 (1.8%) as Inaba and 14 (8.3%) as non-O1/O139 serogroup. The O1 serogroup isolates (154/168, 91.7%) carried the cholera toxin ctxB gene as detected by PCR. Additional virulence genes detected include zot, tcpA, ace, rtxC, toxR, rtxA, tcpP, hlyA and tagA. The most common and rare virulence factors detected among the isolates were rtxC (165 isolates) and tcpP (50 isolates) respectively. All isolates from 2014 and 2015 were multidrug resistant against the selected antibiotics. MLVA differentiated the isolates into 2 large unique clones A and B, with each predominating in a particular year. Spatial analysis showed clustering of most isolates at Ablekuma sub-district. Identification of several virulence genes among the two different genotypes of V. cholerae isolates and resistance to first- and second-line antibiotics, calls for scaleup of preventive strategies to reduce transmission, and strengthening of public health laboratories for rapid antimicrobial susceptibility testing to guide accurate treatment. Our findings support the current WHO licensed cholera vaccines which include both O1 Inaba and Ogawa serotypes.
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Affiliation(s)
- Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Lorenzo Moses Akyeh
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Institute for Environment and Sanitation Studies, University of Ghana, Legon, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - David Opare
- National Public Health and Reference Laboratory, Accra, Ghana
| | - Francine Ntoumi
- Université Marien NGouabi, Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, England, United Kingdom
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- * E-mail:
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Asare P, Otchere ID, Bedeley E, Brites D, Loiseau C, Baddoo NA, Asante-Poku A, Osei-Wusu S, Prah DA, Borrell S, Reinhard M, Forson A, Koram KA, Gagneux S, Yeboah-Manu D. Whole Genome Sequencing and Spatial Analysis Identifies Recent Tuberculosis Transmission Hotspots in Ghana. Front Med (Lausanne) 2020; 7:161. [PMID: 32509791 PMCID: PMC7248928 DOI: 10.3389/fmed.2020.00161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/09/2020] [Indexed: 01/08/2023] Open
Abstract
Whole genome sequencing (WGS) is progressively being used to investigate the transmission dynamics of Mycobacterium tuberculosis complex (MTBC). We used WGS analysis to resolve traditional genotype clusters and explored the spatial distribution of confirmed recent transmission clusters. Bacterial genomes from a total of 452 MTBC isolates belonging to large traditional clusters from a population-based study spanning July 2012 and December 2015 were obtained through short read next-generation sequencing using the illumina HiSeq2500 platform. We performed clustering and spatial analysis using specified R packages and ArcGIS. Of the 452 traditional genotype clustered genomes, 314 (69.5%) were confirmed clusters with a median cluster size of 7.5 genomes and an interquartile range of 4–12. Recent tuberculosis (TB) transmission was estimated as 24.7%. We confirmed the wide spread of a Cameroon sub-lineage clone with a cluster size of 78 genomes predominantly from the Ablekuma sub-district of Accra metropolis. More importantly, we identified a recent transmission cluster associated with isoniazid resistance belonging to the Ghana sub-lineage of lineage 4. WGS was useful in detecting unsuspected outbreaks; hence, we recommend its use not only as a research tool but as a surveillance tool to aid in providing the necessary guided steps to track, monitor, and control TB.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Edmund Bedeley
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Daniela Brites
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sonia Borrell
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
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Otchere ID, van Tonder AJ, Asante-Poku A, Sánchez-Busó L, Coscollá M, Osei-Wusu S, Asare P, Aboagye SY, Ekuban SA, Yahayah AI, Forson A, Baddoo A, Laryea C, Parkhill J, Harris SR, Gagneux S, Yeboah-Manu D. Molecular epidemiology and whole genome sequencing analysis of clinical Mycobacterium bovis from Ghana. PLoS One 2019; 14:e0209395. [PMID: 30830912 PMCID: PMC6398925 DOI: 10.1371/journal.pone.0209395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/19/2019] [Indexed: 11/19/2022] Open
Abstract
Background Bovine tuberculosis (bTB) caused by Mycobacterium bovis is a re-emerging problem in both livestock and humans. The association of some M. bovis strains with hyper-virulence, MDR-TB and disseminated disease makes it imperative to understand the biology of the pathogen. Methods Mycobacterium bovis (15) among 1755 M. tuberculosis complex (MTBC) isolated between 2012 and 2014 were characterized and analyzed for associated patient demography and other risk factors. Five of the M. bovis isolates were whole-genome sequenced and comparatively analyzed against a global collection of published M. bovis genomes. Results Mycobacterium bovis was isolated from 3/560(0.5%) females and 12/1195(1.0%) males with pulmonary TB. The average age of M. bovis infected cases was 46.8 years (7-72years). TB patients from the Northern region of Ghana (1.9%;4/212) had a higher rate of infection with M. bovis (OR = 2.7,p = 0.0968) compared to those from the Greater Accra region (0.7%;11/1543). Among TB patients with available HIV status, the odds of isolating M. bovis from HIV patients (2/119) was 3.3 higher relative to non-HIV patients (4/774). Direct contact with livestock or their unpasteurized products was significantly associated with bTB (p<0.0001, OR = 124.4,95% CI = 30.1–508.3). Two (13.3%) of the M. bovis isolates were INH resistant due to the S315T mutation in katG whereas one (6.7%) was RIF resistant with Q432P and I1491S mutations in rpoB. M. bovis from Ghana resolved as mono-phyletic branch among mostly M. bovis from Africa irrespective of the host and were closest to the root of the global M. bovis phylogeny. M. bovis-specific amino acid mutations were detected among MTBC core genes such as mce1A, mmpL1, pks6, phoT, pstB, glgP and Rv2955c. Additional mutations P6T in chaA, G187E in mgtC, T35A in Rv1979c, S387A in narK1, L400F in fas and A563T in eccA1 were restricted to the 5 clinical M. bovis from Ghana. Conclusion Our data indicate potential zoonotic transmission of bTB in Ghana and hence calls for intensified public education on bTB, especially among risk groups.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Mireia Coscollá
- Institute for Integrative Systems Biology (I2SysBio), University of Valencia-CSIC, Valencia, Spain
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | | | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Akosua Baddoo
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Clement Laryea
- Public Health Department, 37 Military Hospital, Accra, Ghana
| | - Julian Parkhill
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Simon R. Harris
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- * E-mail:
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Asante-Poku A, Asare P, Baddoo NA, Forson A, Klevor P, Otchere ID, Aboagye SY, Osei-Wusu S, Danso EK, Koram K, Gagneux S, Yeboah-Manu D. TB-diabetes co-morbidity in Ghana: The importance of Mycobacterium africanum infection. PLoS One 2019; 14:e0211822. [PMID: 30730937 PMCID: PMC6366779 DOI: 10.1371/journal.pone.0211822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/21/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is a known risk factor for tuberculosis (TB) but little is known on TB-Diabetes Mellitus (TBDM) co-morbidity in Sub-Saharan Africa. METHODS Consecutive TB cases registered at a tertiary facility in Ghana were recruited from September 2012 to April 2016 and screened for DM using random blood glucose and glycated hemoglobin (HbA1c) level. TB patients were tested for other clinical parameters including HIV co-infection and TB lesion location. Mycobacterial isolates obtained from collected sputum samples were characterized by standard methods. Associations between TBDM patients' epidemiological as well as microbiological variables were assessed. RESULTS The prevalence of DM at time of diagnosis among 2990 enrolled TB cases was 9.4% (282/2990). TBDM cases were significantly associated with weight loss, poor appetite, night sweat and fatigue (p<0.001) and were more likely (p<0.001) to have lower lung cavitation 85.8% (242/282) compared to TB Non-Diabetic (TBNDM) patients 3.3% (90/2708). We observed 22.3% (63/282) treatment failures among TBDM patients compared to 3.8% (102/2708) among TBNDM patients (p<0.001). We found no significant difference in the TBDM burden attributed by M. tuberculosis sensu stricto (Mtbss) and Mycobacterium africanum (Maf) and (Mtbss; 176/1836, 9.6% and Maf; 53/468, 11.3%, p = 0.2612). We found that diabetic individuals were suggestively likely to present with TB caused by M. africanum Lineage 6 as opposed to Mtbss (odds ratio (OR) = 1.52; 95% confidence interval (CI): 0.92-2.42, p = 0.072). CONCLUSION Our findings confirms the importance of screening for diabetes during TB diagnosis and highlights the association between genetic diversity and diabetes. in Ghana.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | | | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Pius Klevor
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Sammy Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
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Asandem DA, Asante-Poku A, Asare P, Aboagye SY, Stephen OW, Danso E, Klevor PM, Hayibor KM, Yeboah-Manu D. OMNIgene SPUTUM: A good transport and decontaminating reagent for tuberculosis testing. Int J Mycobacteriol 2018; 7:222-227. [PMID: 30198500 DOI: 10.4103/ijmy.ijmy_102_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Sputum culture is limited to centralized facilities. Thus, samples require transportation from peripheral laboratories to these facilities, compromising specimen quality since it is difficult to maintain cold chain. We evaluated OMNIgene SPUTUM Reagent (OMS) for transporting sputum samples for tuberculosis (TB) testing. The study was carried out at Noguchi Memorial Institute for Medical Research using sputa from Korle Bu Teaching Hospital and La General Hospital in Ghana. Methods In a laboratory-based controlled experiment (CE), sputum contaminants were determined on blood agar before treatment with OMS and N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH). TB testing included smear microscopy, culture, and Xpert MTB/RIF. Afterward, two peripheral laboratories were trained to transport sputum samples with OMS without cold chain. Positivity, negativity, and contamination rates were compared between both methods using Chi-square and Fisher's exact tests. Cohen's Kappa was also used to determine agreements. Results Among 104 sputum samples analyzed in the CE, 93 (89.4%) had bacterial growth on blood agar before decontamination, while 6 (5.8%) and 5 (4.8%) contaminated after NALC-NaOH and OMS treatment, respectively. Contamination was high with NALC-NaOH (12.8%) than OMS (4.3%) on Lowenstein-Jensen media (P < 0.001), but mycobacterial positivity was comparable: NALC-NaOH of 74.5% and OMS of 78.7%. Smear positivity after NALC-NaOH treatment was 89.4% and OMS was 75.9% (P = 0.491). All except one of the samples tested positive by Xpert MTB/RIF after both treatment. Sixteen samples were evaluated in the field experiment and 81.3% yielded positive culture, and no contamination on LJ was observed. Conclusion Our findings indicate that OMS works well as a transport and decontaminating reagent of samples for TB testing.
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Affiliation(s)
- Diana Asema Asandem
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research; West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research; West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Prince Asare
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Sammy Yaw Aboagye
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Osei-Wusu Stephen
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Emelia Danso
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Pius Mawutor Klevor
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kenneth Mawuta Hayibor
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Asare P, Asante-Poku A, Prah DA, Borrell S, Osei-Wusu S, Otchere ID, Forson A, Adjapong G, Koram KA, Gagneux S, Yeboah-Manu D. Reduced transmission of Mycobacterium africanum compared to Mycobacterium tuberculosis in urban West Africa. Int J Infect Dis 2018; 73:30-42. [PMID: 29879521 PMCID: PMC6069673 DOI: 10.1016/j.ijid.2018.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Understanding transmission dynamics is useful for tuberculosis (TB) control. A population-based molecular epidemiological study was conducted to determine TB transmission in Ghana. METHODS Mycobacterium tuberculosis complex (MTBC) isolates obtained from prospectively sampled pulmonary TB patients between July 2012 and December 2015 were characterized using spoligotyping and standard 15-locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) typing for transmission studies. RESULTS Out of 2309 MTBC isolates, 1082 (46.9%) unique cases were identified, with 1227 (53.1%) isolates belonging to one of 276 clusters. The recent TB transmission rate was estimated to be 41.2%. Whereas TB strains of lineage 4 belonging to M. tuberculosis showed a high recent transmission rate (44.9%), reduced recent transmission rates were found for lineages of Mycobacterium africanum (lineage 5, 31.8%; lineage 6, 24.7%). CONCLUSIONS The study findings indicate high recent TB transmission, suggesting the occurrence of unsuspected outbreaks in Ghana. The observed reduced transmission rate of M. africanum suggests other factor(s) (host/environmental) may be responsible for its continuous presence in West Africa.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana; West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana; Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | | | | | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana.
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Otchere ID, Coscollá M, Sánchez-Busó L, Asante-Poku A, Brites D, Loiseau C, Meehan C, Osei-Wusu S, Forson A, Laryea C, Yahayah AI, Baddoo A, Ansa GA, Aboagye SY, Asare P, Borrell S, Gehre F, Beckert P, Kohl TA, N'dira S, Beisel C, Antonio M, Niemann S, de Jong BC, Parkhill J, Harris SR, Gagneux S, Yeboah-Manu D. Comparative genomics of Mycobacterium africanum Lineage 5 and Lineage 6 from Ghana suggests distinct ecological niches. Sci Rep 2018; 8:11269. [PMID: 30050166 PMCID: PMC6062541 DOI: 10.1038/s41598-018-29620-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 07/16/2018] [Indexed: 11/09/2022] Open
Abstract
Mycobacterium africanum (Maf) causes a substantial proportion of human tuberculosis in some countries of West Africa, but little is known on this pathogen. We compared the genomes of 253 Maf clinical isolates from Ghana, including N = 175 Lineage 5 (L5) and N = 78 Lineage 6 (L6). We found that the genomic diversity of L6 was higher than in L5 despite the smaller sample size. Regulatory proteins appeared to evolve neutrally in L5 but under purifying selection in L6. Even though over 90% of the human T cell epitopes were conserved in both lineages, L6 showed a higher ratio of non-synonymous to synonymous single nucleotide variation in these epitopes overall compared to L5. Of the 10% human T cell epitopes that were variable, most carried mutations that were lineage-specific. Our findings indicate that Maf L5 and L6 differ in some of their population genomic characteristics, possibly reflecting different selection pressures linked to distinct ecological niches.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Mireia Coscollá
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Leonor Sánchez-Busó
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chloe Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Conor Meehan
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Audrey Forson
- Chest Clinic, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | | | - Akosua Baddoo
- Chest Clinic, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Gloria Akosua Ansa
- Public Health Department, University of Ghana Hospital, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Florian Gehre
- Institute of Tropical Medicine, Antwerp, Belgium
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Patrick Beckert
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Thomas A Kohl
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Sanoussi N'dira
- National Reference Laboratory for Mycobacteria, Cotonou, Benin
| | - Christian Beisel
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Martin Antonio
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Division of Microbiology & Immunity, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Bouke C de Jong
- Institute of Tropical Medicine, Antwerp, Belgium
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Julian Parkhill
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Simon R Harris
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
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Yeboah-Manu D, Aboagye SY, Asare P, Asante-Poku A, Ampah K, Danso E, Owusu-Mireku E, Nakobu Z, Ampadu E. Laboratory confirmation of Buruli ulcer cases in Ghana, 2008-2016. PLoS Negl Trop Dis 2018; 12:e0006560. [PMID: 29870529 PMCID: PMC6003692 DOI: 10.1371/journal.pntd.0006560] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/15/2018] [Accepted: 05/24/2018] [Indexed: 11/21/2022] Open
Abstract
Background Buruli ulcer (BU), a necrotizing skin infection caused by Mycobacterium ulcerans is the third most important mycobacterial disease globally after tuberculosis and leprosy in immune competent individuals. This study reports on the retrospective analyses of microbiologically confirmed Buruli ulcer (BU) cases in seventy-five health facilities in Ghana. Method/Principal findings Pathological samples were collected from BU lesions and transported either through courier services or by car directly to the laboratory. Samples were processed and analysed by IS2404 PCR, culture and Ziehl-Neelsen staining for detection of acid-fast bacilli. From 2008 to 2016, we analysed by PCR, 2,287 samples of 2,203 cases from seventy-five health facilities in seven regions of Ghana (Ashanti, Brong Ahafo, Central, Eastern, Greater Accra, Northern and Volta). The mean annual positivity rate was 46.2% and ranged between 14.6% and 76.2%. The yearly positivity rates from 2008 to 2016 were 52.3%, 76.2%, 56.7%, 53.8%, 41.2%, 41.5%, 22.9%, 28.5% and 14.6% respectively. Of the 1,020 confirmed cases, the ratio of female to male was 518 and 502 respectively. Patients who were 15 years of age and below accounted for 39.8% of all cases. The median age was 20 years (IQR = 10–43). Ulcerative lesions were 69.2%, nodule (9.6%), plaque (2.9%), oedema (2.5%), osteomyelitis (1.1%), ulcer/oedema (9.5%) and ulcer/plaque (5.2%). Lesions frequently occurred on the lower limbs (57%) followed by the upper limbs (38%), the neck and head (3%) and the least found on the abdomen (2%). Conclusions/Significance Our findings show a decline in microbiological confirmed rates over the years and therefore call for intensive education on case recognition to prevent over-diagnosis as BU cases decline. Buruli ulcer (BU), a necrotizing skin disease caused by Mycobacterium ulcerans, is currently reported in 33 countries, with the greatest disease burden mostly in West African countries along the gulf of Guinea. The lack of pain associated with BU disease enhances delay in seeking medical treatment that could result to complications. The current existing control strategy is early case detection. Previously BU diagnosis was based solely on clinical evidence by a healthcare worker, however, since other skin conditions present similar clinical signs as BU there is the need for further laboratory diagnosis. We microbiological confirmed all clinically diagnosed cases by IS2404 PCR, and Ziehl-Neelsen. We found that over 50% of the clinically diagnosed cases were not BU, thereby averting any unnecessary antimycobacterial treatment with the associated side effects.
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Affiliation(s)
- Dorothy Yeboah-Manu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Sammy Yaw Aboagye
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail:
| | - Prince Asare
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kobina Ampah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Emelia Danso
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Evelyn Owusu-Mireku
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Zuleihatu Nakobu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edwin Ampadu
- National Buruli Ulcer Control Program, Ghana Health Service, Accra, Ghana
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Osei-Wusu S, Amo Omari M, Asante-Poku A, Darko Otchere I, Asare P, Forson A, Otu J, Antonio M, Yeboah-Manu D. Second-line anti-tuberculosis drug resistance testing in Ghana identifies the first extensively drug-resistant tuberculosis case. Infect Drug Resist 2018; 11:239-246. [PMID: 29503573 PMCID: PMC5825993 DOI: 10.2147/idr.s152720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Drug resistance surveillance is crucial for tuberculosis (TB) control. Therefore, our goal was to determine the prevalence of second-line anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates in Ghana. MATERIALS AND METHODS One hundred and seventeen MTBC isolates with varying first-line drug resistance were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin [STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA, gyrB, eis, rrs, tap, whiB7 and tlyA) were then analyzed for mutation. RESULTS Thirty-seven (31.9%) isolates had minimum inhibitory concentration (MIC) values ≥2 µg/mL against STR while 12 (10.3%) isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR) isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC = 3 µg/mL). This isolate also had the highest MIC value for AMK (MIC = 16 µg/mL) and was confirmed as resistant to AMK and MOX by the line probe assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance were: gyrA (G88C) and rrs (A514C and A1401G). CONCLUSION Our findings suggest the need to include routine second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant isolates in our diagnostic algorithm.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West Africa Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Michael Amo Omari
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Jacob Otu
- Medical Research Council Unit, Fajara, The Gambia
| | | | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Aboagye SY, Asare P, Otchere ID, Koka E, Mensah GE, Yirenya-Tawiah D, Yeboah-Manu D. Environmental and Behavioral Drivers of Buruli Ulcer Disease in Selected Communities Along the Densu River Basin of Ghana: A Case-Control Study. Am J Trop Med Hyg 2017; 96:1076-1083. [PMID: 28500810 PMCID: PMC5417198 DOI: 10.4269/ajtmh.16-0749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The exact route of transmission of Mycobacterium ulcerans (MU) (causative agent of Buruli ulcer [BU]), risk factors, and reservoir hosts are not clearly known, although it has been identified as an environmental pathogen. This study assessed potential environmental and behavioral risk factors that influence BU infections. We conducted a case-control study where cases were matched by their demographic characteristics and place of residence. A structured questionnaire was administered to solicit information on the environmental and behavioral factors of participants that may expose them to infection. A total of 176 cases and 176 controls were enrolled into the study. Multivariate conditional logistic regression analysis identified farming in swampy areas (odds ratio [OR] = 4.10, 95% confidence interval [CI] = 3.82–7.18), farming while wearing short clothing (OR = 1,734.1, 95% CI = 68.1–44,120.9), insect bite (OR = 988.3, 95% CI = 31.4–31,115.6), and application of leaves on wounds (OR = 6.23, 95% CI = 4.74–18.11) as potential risk factors. Farming in long clothing (OR = 0.000, 95% CI = 0.00–0.14), washing wound with water and soap (OR = 0.37, 95% CI = 0.29–0.98), and application of adhesive bandage on wounds (OR = 0.31, 95% CI = 0.15–0.82) were found to be protective against BU infection. In the absence of the exact MU transmission mechanisms, education of public in BU-endemic zones on the use of protective clothing during farming activities to limit exposure of the skin and proper wound care management would be essential in the fight against BU.
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Affiliation(s)
- Samuel Yaw Aboagye
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana.,Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Eric Koka
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - George Ekow Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dzidzo Yirenya-Tawiah
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Aboagye SY, Ampah KA, Ross A, Asare P, Otchere ID, Fyfe J, Yeboah-Manu D. Seasonal Pattern of Mycobacterium ulcerans, the Causative Agent of Buruli Ulcer, in the Environment in Ghana. Microb Ecol 2017; 74:350-361. [PMID: 28238016 PMCID: PMC5496970 DOI: 10.1007/s00248-017-0946-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
This study aimed to contribute to the understanding of Mycobacterium ulcerans (MU) ecology by analysing both clinical and environmental samples collected from ten communities along two major river basins (Offin and Densu) associated with Buruli ulcer (BU) at different seasons. We collected clinical samples from presumptive BU cases and environmental samples from ten communities. Following DNA extraction, clinical samples were confirmed by IS2404 PCR and environmental samples were confirmed by targeting MU-specific genes, IS2404, IS2606 and the ketoreductase (KR) using real-time PCR. Environmental samples were first analysed for IS2404; after which, IS2404-positive samples were multiplexed for the IS2606 and KR gene. Our findings indicate an overall decline in BU incidence along both river basins, although incidence at Densu outweighs that of Offin. Overall, 1600 environmental samples were screened along Densu (434, 27 %) and Offin (1166, 73 %) and MU was detected in 139 (9 %) of the combined samples. The positivity of MU along the Densu River basin was 89/434 (20.5 %), whilst that of the Offin River basin was 50/1166 (4.3 %). The DNA was detected mainly in snails (5/6, 83 %), moss (8/40, 20 %), soil (55/586, 9 %) and vegetation (55/675, 8 %). The proportion of MU positive samples recorded was higher during the months with higher rainfall levels (126/1175, 11 %) than during the dry season months (13/425, 3 %). This study indicates for the first time that there is a seasonal pattern in the presence of MU in the environment, which may be related to recent rainfall or water in the soil.
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Affiliation(s)
- Samuel Yaw Aboagye
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana
| | - Kobina Assan Ampah
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Amanda Ross
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
| | - Isaac Darko Otchere
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
| | - Janet Fyfe
- Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia
| | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana.
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Yeboah-Manu D, Asare P, Asante-Poku A, Otchere ID, Osei-Wusu S, Danso E, Forson A, Koram KA, Gagneux S. Spatio-Temporal Distribution of Mycobacterium tuberculosis Complex Strains in Ghana. PLoS One 2016; 11:e0161892. [PMID: 27564240 PMCID: PMC5001706 DOI: 10.1371/journal.pone.0161892] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is a perception that genomic differences in the species/lineages of the nine species making the Mycobacterium tuberculosis complex (MTBC) may affect the efficacy of distinct control tools in certain geographical areas. We therefore analyzed the prevalence and spatial distribution of MTBC species and lineages among isolates from pulmonary TB cases over an 8-year period, 2007-2014. METHODOLOGY Mycobacterial species isolated by culture from consecutively recruited pulmonary tuberculosis patients presenting at selected district/sub-district health facilities were confirmed as MTBC by IS6110 and rpoß PCR and further assigned lineages and sub lineages by spoligotyping and large sequence polymorphism PCR (RDs 4, 9, 12, 702, 711) assays. Patient characteristics, residency, and risks were obtained with a structured questionnaire. We used SaTScan and ArcMap analyses to identify significantly clustered MTBC lineages within selected districts and spatial display, respectively. RESULTS Among 2,551 isolates, 2,019 (79.1%), 516 (20.2%) and 16 (0.6%) were identified as M. tuberculosis sensu stricto (MTBss), M. africanum (Maf), 15 M. bovis and 1 M. caprae, respectively. The proportions of MTBss and Maf were fairly constant within the study period. Maf spoligotypes were dominated by Spoligotype International Type (SIT) 331 (25.42%), SIT 326 (15.25%) and SIT 181 (14.12%). We found M. bovis to be significantly higher in Northern Ghana (1.9% of 212) than Southern Ghana (0.5% of 2339) (p = 0.020). Using the purely spatial and space-time analysis, seven significant MTBC lineage clusters (p< 0.05) were identified. Notable among the clusters were Ghana and Cameroon sub-lineages found to be associated with north and south, respectively. CONCLUSION This study demonstrated that overall, 79.1% of TB in Ghana is caused by MTBss and 20% by M. africanum. Unlike some West African Countries, we did not observe a decline of Maf prevalence in Ghana.
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Affiliation(s)
- Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
- * E-mail:
| | - P. Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - A. Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - I. D. Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - S. Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - E. Danso
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - A. Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-bu, Accra, Ghana
| | - K. A. Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Lamelas A, Ampah KA, Aboagye S, Kerber S, Danso E, Asante-Poku A, Asare P, Parkhill J, Harris SR, Pluschke G, Yeboah-Manu D, Röltgen K. Spatiotemporal Co-existence of Two Mycobacterium ulcerans Clonal Complexes in the Offin River Valley of Ghana. PLoS Negl Trop Dis 2016; 10:e0004856. [PMID: 27434064 PMCID: PMC4951013 DOI: 10.1371/journal.pntd.0004856] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022] Open
Abstract
In recent years, comparative genome sequence analysis of African Mycobacterium ulcerans strains isolated from Buruli ulcer (BU) lesion specimen has revealed a very limited genetic diversity of closely related isolates and a striking association between genotype and geographical origin of the patients. Here, we compared whole genome sequences of five M. ulcerans strains isolated in 2004 or 2013 from BU lesions of four residents of the Offin river valley with 48 strains isolated between 2002 and 2005 from BU lesions of individuals residing in the Densu river valley of Ghana. While all M. ulcerans isolates from the Densu river valley belonged to the same clonal complex, members of two distinct clonal complexes were found in the Offin river valley over space and time. The Offin strains were closely related to genotypes from either the Densu region or from the Asante Akim North district of Ghana. These results point towards an occasional involvement of a mobile reservoir in the transmission of M. ulcerans, enabling the spread of bacteria across different regions. Infection with Mycobacterium ulcerans causes the debilitating skin disease Buruli ulcer. Until today, transmission pathways and reservoirs of this emerging pathogen are not well understood. Generally, it is assumed that infection occurs after contact with potential environmental sources of M. ulcerans through puncture wounds or lacerations or via invertebrate vectors, such as aquatic insects contaminated with the bacteria. Comparative genome analyses of M. ulcerans strains isolated from patients living in the same BU endemic areas have revealed a close relationship between the genotype detected and the geographical origin, indicating that the reservoir of the pathogen is relatively fixed in space. In the present study, we report the co-circulation of two distinct M. ulcerans clonal complexes in the same BU endemic area over space and time. Since members of these two clonal complexes were closely related to strains from either the Densu river valley or the Asante Akim North district of Ghana, we conclude that a mobile reservoir of M. ulcerans may be involved in the occasional spread of the bacteria across different regions.
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Affiliation(s)
- Araceli Lamelas
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Red de Estudios Moleculares Avanzados, Instituto de Ecologia, A.C., Veracruz, México
| | - Kobina Assan Ampah
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Noguchi Memorial Institute for Medical Research, Legon, Ghana
| | - Samuel Aboagye
- Noguchi Memorial Institute for Medical Research, Legon, Ghana
| | - Sarah Kerber
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Emelia Danso
- Noguchi Memorial Institute for Medical Research, Legon, Ghana
| | | | - Prince Asare
- Noguchi Memorial Institute for Medical Research, Legon, Ghana
| | | | | | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | | | - Katharina Röltgen
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Ampah KA, Nickel B, Asare P, Ross A, De-Graft D, Kerber S, Spallek R, Singh M, Pluschke G, Yeboah-Manu D, Röltgen K. A Sero-epidemiological Approach to Explore Transmission of Mycobacterium ulcerans. PLoS Negl Trop Dis 2016; 10:e0004387. [PMID: 26808978 PMCID: PMC4726553 DOI: 10.1371/journal.pntd.0004387] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/22/2015] [Indexed: 01/30/2023] Open
Abstract
The debilitating skin disease Buruli ulcer (BU) is caused by infection with Mycobacterium ulcerans. While various hypotheses on potential reservoirs and vectors of M. ulcerans exist, the mode of transmission has remained unclear. Epidemiological studies have indicated that children below the age of four are less exposed to the pathogen and at lower risk of developing BU than older children. In the present study we compared the age at which children begin to develop antibody responses against M. ulcerans with the age pattern of responses to other pathogens transmitted by various mechanisms. A total of 1,352 sera from individuals living in the BU endemic Offin river valley of Ghana were included in the study. While first serological responses to the mosquito transmitted malaria parasite Plasmodium falciparum and to soil transmitted Strongyloides helminths emerged around the age of one and two years, sero-conversion for M. ulcerans and for the water transmitted trematode Schistosoma mansoni occurred at around four and five years, respectively. Our data suggest that exposure to M. ulcerans intensifies strongly at the age when children start to have more intense contact with the environment, outside the small movement range of young children. Further results from our serological investigations in the Offin river valley also indicate ongoing transmission of Treponema pallidum, the causative agent of yaws.
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Affiliation(s)
- Kobina Assan Ampah
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Beatrice Nickel
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Amanda Ross
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel De-Graft
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Sarah Kerber
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ralf Spallek
- LIONEX Diagnostics & Therapeutics, Braunschweig, Germany
| | - Mahavir Singh
- LIONEX Diagnostics & Therapeutics, Braunschweig, Germany
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Katharina Röltgen
- Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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