title: Mycobacterium africanum is associated with patient ethnicity in Ghana.
abstract: Mycobacterium africanum is a member of the Mycobacterium tuberculosis complex (MTBC) and an important cause of human tuberculosis in West Africa that is rarely observed elsewhere. Here we genotyped 613 MTBC clinical isolates from Ghana, and searched for associations between the different phylogenetic lineages of MTBC and patient variables. We found that 17.1% (105/613) of the MTBC isolates belonged to M. africanum, with the remaining belonging to M. tuberculosis sensu stricto. No M. bovis was identified in this sample. M. africanum was significantly more common in tuberculosis patients belonging to the Ewe ethnic group (adjusted odds ratio: 3.02; 95% confidence interval: 1.67-5.47, p<0.001). Stratifying our analysis by the two phylogenetic lineages of M. africanum (i.e. MTBC Lineages 5 and 6) revealed that this association was mainly driven by Lineage 5 (also known as M. africanum West Africa 1). Our findings suggest interactions between the genetic diversity of MTBC and human diversity, and offer a possible explanation for the geographical restriction of M. africanum to parts of West Africa.
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Adwoa
authors.initials: A
authors.lastname: Asante-Poku
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Isaac Darko
authors.initials: ID
authors.lastname: Otchere
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Samuel Y
authors.initials: SY
authors.lastname: Aboagye
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Stucki
authors.affiliation: University of Basel, Basel, Switzerland; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Hattendorf
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Borrell
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Feldmann
authors.affiliation: Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Emelia
authors.initials: E
authors.lastname: Danso
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gagneux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005838:Genotype; D005869:Ghana; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000235:genetics; D010802:Phylogeny; D014376:Tuberculosis / Q000208:ethnology* / Q000382:microbiology