RT Journal Article
SR Electronic
T1 Pulmonary tuberculosis in Harare, Zimbabwe: analysis by spoligotyping
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 346
OP 350
DO 10.1136/thx.53.5.346
VO 53
IS 5
A1 R S Heyderman
A1 M Goyal
A1 P Roberts
A1 S Ushewokunze
A1 S Zizhou
A1 B G Marshall
A1 Robert Makombe
A1 J D A Van Embden
A1 P R Mason
A1 R J Shaw
YR 1998
UL http://thorax.bmj.com/content/53/5/346.abstract
AB BACKGROUND Over the last 10 years there has been a fourfold increase in cases of tuberculosis in Harare, Zimbabwe. The use of molecular epidemiology to understand tuberculosis transmission in this epidemic has been hampered by the availability of suitable culture facilities. A study was therefore undertaken to explore the potential of spoligotyping, a polymerase chain reaction based technique that does not require tuberculosis culture.METHODS Adults attending a chest clinic with clinical or radiological pulmonary tuberculosis and one smear positive sputum were enrolled over one month. Demographic, socioeconomic, and clinical data were gathered using a standardised questionnaire. Molecular fingerprinting of genomic DNA recovered from sputum was performed by spoligotyping.RESULTS Sixty one subjects (median age 28 years (range 18–73); 61% men) were recruited and 57 provided adequate sputum samples. Recent rural-urban migration or immigration was not common; 40% of subjects lived in crowded living conditions. DNA suitable for spoligotyping was recovered from 28 patients and 20 different genotypes of Mycobacterium tuberculosis were identified. Fifteen patients were infected with an M tuberculosis strain shared by one or more individuals. Patients infected with a shared spoligotype were not closely linked geographically within Harare, but were more likely to live in overcrowded conditions (69% versus 23%; odds ratio 6.85 (95% CI 1.2 to 47), p = 0.026). Analysis of the patients’ original rural family homes revealed two geographically related spoligotype clusters.CONCLUSIONS Spoligotyping may yield valuable molecular typing information in populations where tuberculosis culture is not available. This novel technique requires further development and evaluation in larger epidemiological studies.