title: Tuberculosis Caused by Mycobacterium africanum, United States, 2004-2013.
abstract: Mycobacterium africanum is endemic to West Africa and causes tuberculosis (TB). We reviewed reported cases of TB in the United States during 2004-2013 that had lineage assigned by genotype (spoligotype and mycobacterial interspersed repetitive unit variable number tandem repeats). M. africanum caused 315 (0.4%) of 73,290 TB cases with lineage assigned by genotype. TB caused by M. africanum was associated more with persons from West Africa (adjusted odds ratio [aOR] 253.8, 95% CI 59.9-1,076.1) and US-born black persons (aOR 5.7, 95% CI 1.2-25.9) than with US-born white persons. TB caused by M. africanum did not show differences in clinical characteristics when compared with TB caused by M. tuberculosis. Clustered cases defined as >2 cases in a county with identical 24-locus mycobacterial interspersed repetitive unit genotypes, were less likely for M. africanum (aOR 0.1, 95% CI 0.1-0.4), which suggests that M. africanum is not commonly transmitted in the United States.
authors.forename: Aditya
authors.initials: A
authors.lastname: Sharma
authors.forename: Emily
authors.initials: E
authors.lastname: Bloss
authors.forename: Charles M
authors.initials: CM
authors.lastname: Heilig
authors.forename: Eleanor S
authors.initials: ES
authors.lastname: Click
mesh_terms: D000354:Africa, Western; D005838:Genotype; D006801:Humans; D009161:Mycobacterium / Q000235:genetics; D009169:Mycobacterium tuberculosis / Q000235:genetics; D013045:Species Specificity; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D014481:United States / Q000453:epidemiology
keywords: Mycobacterium africanum; United States; bacteria; genotype; surveillance; tuberculosis and other mycobacteria