title: Distribution and transmission of Mycobacterium tuberculosis complex lineages among children in peri-urban Kampala, Uganda.
abstract: BACKGROUND
  To gain insight into the transmission of tuberculosis (TB) in peri-urban Kampala-Uganda, we performed a household contact study using children as a surrogate for recent transmission of Mycobacterium tuberculosis (MTB). Using this approach, we sought to understand M. tuberculosis complex (MTBC) lineage diversity, distribution and how these relate to TB transmission to exposed children.
  
  
  METHODS
  MTBC isolates from children aged ≤ 15 years, collected from 2002 to 2010 in a household-contact study, were analyzed using a LightCycler RT-PCR SNP genotyping assay (LRPS). The resultant genotypic data was used to determine associations between MTBC lineage and the children's clinical and epidemiological characteristics.
  
  
  CONCLUSIONS
  Of the 761 children surveyed, 9% (69/761) had culture-positive TB an estimate in the range of global childhood TB; of these 71% (49/69) were infected with an MTBC strain of the "Uganda family", 17% (12/69) infected with MTBC lineage 4 strains other than MTBC Uganda family and 12% (8/69) infected with MTBC lineage 3, thereby disproportionately causing TB in the study area. Overall the data showed no correlation between the MTBC lineages studied and transmission (OR = 0.304; P-value = 0.251; CI: 95%; 0.039-2.326) using children a proxy for TB transmission.
  
  
  CONCLUSIONS
  Our findings indicate that MTBC Uganda family strains are the main cause of TB in children in peri-urban Kampala. Furthermore, MTBC lineages did not differ in their transmissibility to children.
authors.affiliation: Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda. wamps@covab.mak.ac.ug.|Department of Bio-molecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Bio Security, Makerere University, Kampala, Uganda. wamps@covab.mak.ac.ug.
authors.forename: Eddie M
authors.initials: EM
authors.lastname: Wampande
authors.affiliation: Department of Pediatrics and Child Health College of Health Sciences, Makerere University, Kampala, Uganda. mupez@yahoo.com.
authors.forename: Ezekiel
authors.initials: E
authors.lastname: Mupere
authors.affiliation: The Johns Hopkins School of medicine, Department of Pediatricss, Baltimore, USA. djagana1@jhmi.edu.
authors.forename: Devan
authors.initials: D
authors.lastname: Jaganath
authors.affiliation: Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. mnsereko@mucwru.or.ug.
authors.forename: Mary
authors.initials: M
authors.lastname: Nsereko
authors.affiliation: Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. hmk@chs.mak.ac.ug.|Department of Medicine College of Health Sciences, Makerere University, Kampala, Uganda. hmk@chs.mak.ac.ug.
authors.forename: Harriet K
authors.initials: HK
authors.lastname: Mayanja
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. EisenachKathleenD@uams.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Eisenach
authors.affiliation: Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. whb@case.edu.|Tuberculosis Research Unit, School of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio, USA. whb@case.edu.
authors.forename: W Henry
authors.initials: WH
authors.lastname: Boom
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. Sebastien.gagneux@unibas.ch.|University of Basel, Basel, Switzerland. Sebastien.gagneux@unibas.ch.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gagneux
authors.affiliation: Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O box 7072, Kampala, Uganda. mlj10@case.edu.|Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. mlj10@case.edu.
authors.forename: Moses L
authors.initials: ML
authors.lastname: Joloba
mesh_terms: D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics*; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000382:microbiology* / Q000635:transmission*; D014454:Uganda / Q000453:epidemiology; D014505:Urban Population