TY - JOUR
T1 - Back-to-Africa introductions of Mycobacterium tuberculosis as the main cause of tuberculosis in Dar es Salaam, Tanzania
AU - Zwyer, Michaela
AU - Rutaihwa, Liliana K.
AU - Windels, Etthel
AU - Hella, Jerry
AU - Menardo, Fabrizio
AU - Sasamalo, Mohamed
AU - Sommer, Gregor
AU - Schmülling, Lena
AU - Borrell, Sonia
AU - Reinhard, Miriam
AU - Dötsch, Anna
AU - Hiza, Hellen
AU - Stritt, Christoph
AU - Sikalengo, George
AU - Fenner, Lukas
AU - De Jong, Bouke C.
AU - Kato-Maeda, Midori
AU - Jugheli, Levan
AU - Ernst, Joel D.
AU - Niemann, Stefan
AU - Jeljeli, Leila
AU - Ballif, Marie
AU - Egger, Matthias
AU - Rakotosamimanana, Niaina
AU - Yeboah-Manu, Dorothy
AU - Asare, Prince
AU - Malla, Bijaya
AU - Dou, Horng Yunn
AU - Zetola, Nicolas
AU - Wilkinson, Robert J.
AU - Cox, Helen
AU - Carter, E. Jane
AU - Gnokoro, Joachim
AU - Yotebieng, Marcel
AU - Gotuzzo, Eduardo
AU - Abimiku, Alashle
AU - Avihingsanon, Anchalee
AU - Xu, Zhi Ming
AU - Fellay, Jacques
AU - Portevin, Damien
AU - Reither, Klaus
AU - Stadler, Tanja
AU - Gagneux, Sebastien
AU - Brites, Daniela
N1 - Publisher Copyright:
© 2023 Zwyer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/4
Y1 - 2023/4
N2 - In settings with high tuberculosis (TB) endemicity, distinct genotypes of the Mycobacterium tuberculosis complex (MTBC) often differ in prevalence. However, the factors leading to these differences remain poorly understood. Here we studied the MTBC population in Dar es Salaam, Tanzania over a six-year period, using 1,082 unique patient-derived MTBC whole-genome sequences (WGS) and associated clinical data. We show that the TB epidemic in Dar es Salaam is dominated by multiple MTBC genotypes introduced to Tanzania from different parts of the world during the last 300 years. The most common MTBC genotypes deriving from these introductions exhibited differences in transmission rates and in the duration of the infectious period, but little differences in overall fitness, as measured by the effective reproductive number. Moreover, measures of disease severity and bacterial load indicated no differences in virulence between these genotypes during active TB. Instead, the combination of an early introduction and a high transmission rate accounted for the high prevalence of L3.1.1, the most dominant MTBC genotype in this setting. Yet, a longer coexistence with the host population did not always result in a higher transmission rate, suggesting that distinct life-history traits have evolved in the different MTBC genotypes. Taken together, our results point to bacterial factors as important determinants of the TB epidemic in Dar es Salaam.
AB - In settings with high tuberculosis (TB) endemicity, distinct genotypes of the Mycobacterium tuberculosis complex (MTBC) often differ in prevalence. However, the factors leading to these differences remain poorly understood. Here we studied the MTBC population in Dar es Salaam, Tanzania over a six-year period, using 1,082 unique patient-derived MTBC whole-genome sequences (WGS) and associated clinical data. We show that the TB epidemic in Dar es Salaam is dominated by multiple MTBC genotypes introduced to Tanzania from different parts of the world during the last 300 years. The most common MTBC genotypes deriving from these introductions exhibited differences in transmission rates and in the duration of the infectious period, but little differences in overall fitness, as measured by the effective reproductive number. Moreover, measures of disease severity and bacterial load indicated no differences in virulence between these genotypes during active TB. Instead, the combination of an early introduction and a high transmission rate accounted for the high prevalence of L3.1.1, the most dominant MTBC genotype in this setting. Yet, a longer coexistence with the host population did not always result in a higher transmission rate, suggesting that distinct life-history traits have evolved in the different MTBC genotypes. Taken together, our results point to bacterial factors as important determinants of the TB epidemic in Dar es Salaam.
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U2 - 10.1371/journal.ppat.1010893
DO - 10.1371/journal.ppat.1010893
M3 - Article
C2 - 37014917
AN - SCOPUS:85152627695
SN - 1553-7366
VL - 19
JO - PLoS Pathogens
JF - PLoS Pathogens
IS - 4
M1 - e1010893
ER -
