title: Learning from epidemiological, clinical, and immunological studies on Mycobacterium africanum for improving current understanding of host-pathogen interactions, and for the development and evaluation of diagnostics, host-directed therapies, and vaccines for tuberculosis.
abstract: Mycobacterium africanum comprises two phylogenetic lineages within the Mycobacterium tuberculosis complex (MTBC). M. africanum was first described and isolated in 1968 from the sputum of a Senegalese patient with pulmonary tuberculosis (TB) and it has been identified increasingly as an important cause of human TB, particularly prevalent in West Africa. The restricted geographical distribution of M. africanum, in contrast to the widespread global distribution of other species of MTBC, requires explanation. Available data indicate that M. africanum may also have important differences in transmission, pathogenesis, and host-pathogen interactions, which could affect the evaluation of new TB intervention tools (diagnostics and vaccines)-those currently in use and those under development. The unequal geographical distribution and spread of MTBC species means that individual research findings from one country or region cannot be generalized across the continent. Thus, generalizing data from previous and ongoing research studies on MTBC may be inaccurate and inappropriate. A major rethink is required regarding the design and structure of future clinical trials of new interventions. The West, Central, East, and Southern African EDCTP Networks of Excellence provide opportunities to take forward these pan-Africa studies. More investments into molecular, epidemiological, clinical, diagnostic, and immunological studies across the African continent are required to enable further understanding of host-M. africanum interactions, leading to the development of more specific diagnostics, biomarkers, host-directed therapies, and vaccines for TB.
authors.affiliation: Center for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK; National Institute of Health Research, Biomedical Research Centre at UCL Hospitals, London, UK; UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.affiliation: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
authors.forename: Isaac Darko
authors.initials: ID
authors.lastname: Otchere
authors.affiliation: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
authors.forename: Gloria Ivy
authors.initials: GI
authors.lastname: Mensah
authors.affiliation: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
authors.forename: Adwoa
authors.initials: A
authors.lastname: Asante-Poku
authors.affiliation: Mycobacterial Unit, Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Fajara, The Gambia.
authors.forename: Florian
authors.initials: F
authors.lastname: Gehre
authors.affiliation: Therapeutic Immunology (TIM) Division, Department of Laboratory Medicine, Karolinska University Hospital Huddinge, and Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Maeurer
authors.affiliation: Center for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK; UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bates
authors.affiliation: UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mwaba
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
authors.forename: Francine
authors.initials: F
authors.lastname: Ntoumi
authors.affiliation: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, Accra, Ghana. Electronic address: dyeboah-manu@noguchi.ug.edu.gh.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D005838:Genotype; D054884:Host-Pathogen Interactions / Q000276:immunology*; D006801:Humans; D058889:Molecular Typing; D009161:Mycobacterium / Q000145:classification / Q000235:genetics / Q000276:immunology* / Q000472:pathogenicity*; D010802:Phylogeny; D015995:Prevalence; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D032581:Tuberculosis Vaccines / Q000276:immunology*
chemical_list: D032581:Tuberculosis Vaccines
keywords: Africa; Diagnostics; EDCTP; Host; Mycobacterium africanum; Mycobacterium tuberculosis complex; TB; Vaccines