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Background: Tuberculosis is an ancient disease which continued to be one of the major public health problems facing mankind. Characterization of the prevailing Mycobacterium tuberculosis lineages and clones is important for locating the origin, evolution and spreading dynamics of a particular Mycobacterium tuberculosis clone, which is often difficult to be identified by traditional epidemiological investigations alone.
Methods: A total of 130 sputum samples were collected cross-sectionaly from all consecutive pulmonary tuberculosis patients attending Debremarkos Referral Hospital and fulfilling the inclusion criteria. All sampled sputa were kept at 40c for a week until transportation on ice to tuberculosis laboratory at the Armauer Hansen Research Institute (AHRI) in Addis Ababa. At AHRI, the sputa were cultured on Lowenstein-Jensen (LJ) egg medium and the isolates were then characterized using deletion typing and spoligotyping. The data obtained were entered using Epi- Data entry version 3.1 software and analyzed using SPSS version 17.0 software.
Results: Region of difference analysis for RD9 (RD9 typing) of all the isolates indicated that 48 out of 50 isolates were with intact RD9 and therefore Mycobacterium tuberculosis species. Spoligotyping of 46 Mycobacterium tuberculosis isolates and analysis of the spoligotyping data using an international database,SpolDB4, showed that SIT 910 with 7 isolates and SIT 149 with 5 isolates were the predominant spoligotypes in the area. Nine spoligotypes, one with a cluster of five isolates and eight single strains, were never reported anywhere in the world and new to the international database, SpolDB4. The most prevalent lineage identified in this study was the Europe-American lineage 65% (13/20).
Conclusions and recommendations: Generally this study provided molecular evidence of circulating strains in pulmonary tuberculosis patients of North West Ethiopia. Further studies covering all regions of Ethiopia should be performed in order to map all the strains circulating in the country.
Learning Objectives: Articulate the strain diversity of Mycobacterium tuberculosis isolates from rural indigenous people in North West Ethiopia Analyze the strain variation of M.tuberculosis isolates from the area and compare it with the predominant lineages and strains in the world. Indicate how initiation of intervention methods might be important to break the chain of transmission among the indigenous people,North West Ethiopia