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Int J Tuberc Lung Dis. 2007 Apr;11(4):450-6.

Clinical presentation and outcome of tuberculosis patients infected by M. africanum versus M. tuberculosis.

Author information

1
Bacterial Diseases Programme, Medical Research Council Laboratories, Banjul, The Gambia. bdejong@mrc.gm

Abstract

SETTING:

A tuberculosis (TB) case contact study in the Gambia.

OBJECTIVE:

To test whether Mycobacterium africanum, which has lost around 68 kb compared with M. tuberculosis sensu stricto, causes less severe TB disease.

DESIGN:

We genotyped mycobacterial isolates and compared clinical and radiological characteristics as well as outcome data of M. africanum-infected TB patients with those infected with M. tuberculosis.

RESULTS:

Of 317 index cases, 301 had a mycobacterial isolate available, 290 of which had an interpretable spoligotype pattern. Of these, 110 isolates (38%) were M. africanum and 180 (62%) were M. tuberculosis. M. africanum cases had lower body mass indices (17 vs. 17.45 for M. tuberculosis-infected patients, P = 0.029) and their radiographic disease was more extensive (96% vs. 89% had at least moderately severe radiographic changes, P = 0.031). Outcome on treatment was similar (2.8% of human immunodeficiency virus [HIV] negative M. africanum patients died on treatment vs. 3.0% of M. tuberculosis patients, P = 0.95).

CONCLUSION:

M. africanum causes sputum smear-positive tuberculosis disease that is at least as severe as that caused by M. tuberculosis sensu stricto. Further clinical comparisons may be helpful in smear-negative patients and HIV-TB co-infected patients, and to identify whether there is any difference in time to develop disease.

PMID:
17394693
[Indexed for MEDLINE]

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