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Viegas S.O.,National Institute of Health | Viegas S.O.,Eduardo Mondlane University | Viegas S.O.,Karolinska Institutet | Machado A.,Eduardo Mondlane University | And 14 more authors.
PLoS ONE | Year: 2013

The Beijing genotype is a lineage of Mycobacterium tuberculosis that is distributed worldwide and responsible for large epidemics, associated with multidrug-resistance. However, its distribution in Africa is less understood due to the lack of data. Our aim was to investigate the prevalence and possible transmission of Beijing strains in Mozambique by a multivariate analysis of genotypic, geographic and demographic data. A total of 543 M. tuberculosis isolates from Mozambique were spoligotyped. Of these, 33 were of the Beijing lineage. The genetic relationship between the Beijing isolates were studied by identification of genomic deletions within some Regions of Difference (RD), Restriction Fragment Length Polymorphism (RFLP) and Mycobacterial Interspersed Repetivie Unit - variable number tandem repeat (MIRU-VNTR). Beijing strains from South Africa, representing different sublineages were included as reference strains. The association between Beijing genotype, Human Immunodeficiency Virus (HIV) serology and baseline demographic data was investigated. HIV positive serostatus was significantly (p=0.023) more common in patients with Beijing strains than in patients with non-Beijing strains in a multivariable analysis adjusted for age, sex and province (14 (10.9%) of the 129 HIV positive patients had Beijing strains while 6/141 (4.3%) of HIV negative patients had Beijing strains). The majority of Beijing strains were found in the Southern region of Mozambique, particularly in Maputo City (17%). Only one Beijing strain was drug resistant (multi-drug resistant). By combined use of RD and spoligotyping, three genetic sublineages could be tentatively identified where a distinct group of four isolates had deletion of RD150, a signature of the "sublineage 7" recently emerging in South Africa. The same group was very similar to South African "sublineage 7" by RFLP and MIRU-VNTR, suggesting that this sublineage could have been recently introduced in Mozambique from South Africa, in association with HIV infection. © 2013 Viegas et al.

Viegas S.O.,Eduardo Mondlane University | Viegas S.O.,National Institute of Health | Viegas S.O.,Karolinska Institutet | MacHado A.,Eduardo Mondlane University | And 15 more authors.
BMC Microbiology | Year: 2010

Abstract. Background. Mozambique is one of the countries with the highest burden of tuberculosis (TB) in Sub-Saharan Africa, and information on the predominant genotypes of Mycobacterium tuberculosis circulating in the country are important to better understand the epidemic. This study determined the predominant strain lineages that cause TB in Mozambique. Results. A total of 445 M. tuberculosis isolates from seven different provinces of Mozambique were characterized by spoligotyping and resulting profiles were compared with the international spoligotyping database SITVIT2. The four most predominant lineages observed were: the Latin-American Mediterranean (LAM, n = 165 or 37%); the East African-Indian (EAI, n = 132 or 29.7%); an evolutionary recent but yet ill-defined T clade, (n = 52 or 11.6%); and the globally-emerging Beijing clone, (n = 31 or 7%). A high spoligotype diversity was found for the EAI, LAM and T lineages. Conclusions. The TB epidemic in Mozambique is caused by a wide diversity of spoligotypes with predominance of LAM, EAI, T and Beijing lineages. © 2010 Viegas et al; licensee BioMed Central Ltd.

De Oliveira G.P.,Tuberculosis National Control Program | Torrens A.W.,Tuberculosis National Control Program | Bartholomay P.,Tuberculosis National Control Program | Barreira D.,Tuberculosis National Control Program
Brazilian Journal of Infectious Diseases | Year: 2013

Objective: To describe tuberculosis epidemiological situation in Brazil, as well as program performance indicators in 2001-2010 period, and discuss the relationship between changes observed and control measures implemented in this century first decade. Methods: It is a descriptive study, data source was the Information System for Notifiable Diseases (Sinan), Mortality Information System (SIM), Unified Health System Hospital Information System (SIH/SUS) and TB Multidrug-resistant Surveillance System (MDR-TB/SS). Indicators analyzed were organized into four major groups: TB control program (TCP) coverage and case detection; morbidity; treatment and TCP performance; and mortality. Results: In the years analyzed there was a decrease in the number of new cases and incidence rate, mortality reduction (relative and absolute), and improvement in TB detection and diagnosis, as well in TB/HIV coinfection and drug resistance. However, little progress was found in contact investigation, diagnosis in primary care and TB cure rate. Discussion: Results showed many advances in tuberculosis control in the 10 years analyzed, but it also points to serious obstacles that need to be solved so Brazil can eliminate tuberculosis as a public health problem. © 2013 Elsevier Editora Ltda.

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