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Information on the different spoligotype families of Mycobacterium tuberculosis in Tanzania is limited,
and where available, restricted to small geographical areas. This article describes the genetic profile of M.
tuberculosis across Tanzania and suggests how spoligotype families might affect drug resistance and treatment
outcomes for smear positive pulmonary tuberculosis patients in Tanzania. We conducted the study from 2006
to 2008, and the isolates were obtained from samples collected under the routine drug resistance surveillance
system. The isolates were from specimens collected from 2001 to 2007, and stored at the Central and
Reference Tuberculosis Laboratory. A total of 487 isolates from 23 regions in the country were spoligotyped.
We were able to retrieve clinical information for 446 isolates only. Out of the 487 isolates spoligotyped,
195(40.0%) belonged to the Central Asian (CAS) family, 84 (17.5%) to the Latin American Mediterranean (LAM)
family, 49 (10.1%) to the East-African Indian (EAI) family, and 33 (6.8%) to the Beijing family. Other isolates
included 1 (0.2%) for H37Rv, 10 (2.1%) for Haarlem, 4 (0.8%) for S family, 58 (11.9%) for T family and 52 (10.7%) for
unclassified. No spoligotype patterns were consistent with M. bovis. Regarding treatment outcomes, the cure
rate was 80% with no significant variation among the spoligotype families. The overall level of MDR TB was
2.5% (3/121), with no significant difference among the spoligotype families. All Beijing strains (11.8%, 30/254)
originated from the Eastern and Southern zones of the country, of which 80% were from Dar es Salaam.
Isolates from the CAS and T families were reported disproportionately from the Eastern-Southern zone, and
EAI and LAM families from the Northern-Lake zones but the difference was not statistically significant. Five
isolates were identified as non-tuberculous Mycobacteria. In conclusion, M. tuberculosis isolates from
pulmonary tuberculosis cases in Tanzania were classified mostly within the CAS, LAM, and EAI and T families,
while the Beijing family comprised about 7% isolates only. Consistently good treatment outcomes were
recorded across these spoligotype families. The proportion of drug resistance strains was low. The findings
also suggest variation of spoligotype families with varying geographical localities within the country, and
identify this area for further research to confirm this finding. |
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