Title |
A complex scenario of tuberculosis transmission is revealed through genetic and epidemiological surveys in Porto
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Published in |
BMC Infectious Diseases, January 2018
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DOI | 10.1186/s12879-018-2968-1 |
Pubmed ID | |
Authors |
Teresa Rito, Carlos Matos, Carlos Carvalho, Henrique Machado, Gabriela Rodrigues, Olena Oliveira, Eduarda Ferreira, Jorge Gonçalves, Lurdes Maio, Clara Morais, Helena Ramos, João Tiago Guimarães, Catarina L. Santos, Raquel Duarte, Margarida Correia-Neves |
Abstract |
Tuberculosis (TB) incidence is decreasing worldwide and eradication is becoming plausible. In low-incidence countries, intervention on migrant populations is considered one of the most important strategies for elimination. However, such measures are inappropriate in European areas where TB is largely endemic, such as Porto in Portugal. We aim to understand transmission chains in Porto through a genetic characterization of Mycobacterium tuberculosis strains and through a detailed epidemiological evaluation of cases. We genotyped the M. tuberculosis strains using the MIRU-VNTR system. We performed an evolutionary reconstruction of the genotypes with median networks, used in this context for the first time. TB cases from a period of two years were evaluated combining genetic, epidemiological and georeferencing information. The data reveal a unique complex scenario in Porto where the autochthonous population acts as a genetic reservoir of M. tuberculosis diversity with discreet episodes of transmission, mostly undetected using classical epidemiology alone. Although control policies have been successful in decreasing incidence in Porto, the discerned complexity suggests that, for elimination to be a realistic goal, strategies need to be adjusted and coupled with a continuous genetic characterization of strains and detailed epidemiological evaluation, in order to successfully identify and interrupt transmission chains. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 3 | 23% |
United States | 2 | 15% |
Brazil | 1 | 8% |
France | 1 | 8% |
Argentina | 1 | 8% |
Venezuela, Bolivarian Republic of | 1 | 8% |
Portugal | 1 | 8% |
United Kingdom | 1 | 8% |
Unknown | 2 | 15% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 9 | 69% |
Scientists | 2 | 15% |
Science communicators (journalists, bloggers, editors) | 1 | 8% |
Practitioners (doctors, other healthcare professionals) | 1 | 8% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 41 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 5 | 12% |
Student > Master | 4 | 10% |
Researcher | 4 | 10% |
Lecturer | 3 | 7% |
Student > Doctoral Student | 3 | 7% |
Other | 5 | 12% |
Unknown | 17 | 41% |
Readers by discipline | Count | As % |
---|---|---|
Immunology and Microbiology | 6 | 15% |
Biochemistry, Genetics and Molecular Biology | 5 | 12% |
Medicine and Dentistry | 4 | 10% |
Social Sciences | 3 | 7% |
Nursing and Health Professions | 2 | 5% |
Other | 3 | 7% |
Unknown | 18 | 44% |