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INCIDENCE AND TRANSMISSION PATTERNS OF TUBERCULOSIS AMONG INDIGENOUS POPULATIONS IN BRAZIL
Genotyping
Microbiology
Molecular epidemiology
South American indigenous people
Author
Affilliation
Laboratório Central de Saúde Pública de Mato Grosso do Sul. Seção de Micobacteriologia. Campo Grande, MS, Brasil.
Instituto Adolfo Lutz. Núcleo de Tuberculose e Micobacteriose. São Paulo, SP, Brasil.
University of California. School of Public Health. Division of Infectious Diseases & Vaccinology. Berkeley, CA, USA.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.
Universidade Católica Dom Bosco. Campo Grande, MS, Brasil.
Ministério da Saúde. Programa Nacional de Controle da Tuberculose. Brasília, DF, Brasil.
Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande, MS, Brasil.
Instituto Adolfo Lutz. Núcleo de Tuberculose e Micobacteriose. São Paulo, SP, Brasil.
University of California. School of Public Health. Division of Infectious Diseases & Vaccinology. Berkeley, CA, USA.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.
Universidade Católica Dom Bosco. Campo Grande, MS, Brasil.
Ministério da Saúde. Programa Nacional de Controle da Tuberculose. Brasília, DF, Brasil.
Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande, MS, Brasil.
Abstract
Approximately 10% of the Brazilian indigenous population lives in the state of Mato Grosso do Sul (MS), where a large number of new cases of tuberculosis (TB) are reported. This study was conducted to assess TB occurrence, transmission and the utility of TB diagnosis based on the Ogawa-Kudoh (O-K) culture method in this remote population. The incidence of TB was estimated by a retrospective review of the surveillance data maintained by the Notifiable Diseases Surveillance System for the study region. The TB transmission pattern among indigenous people was assessed by genotyping Mycobacterium tuberculosis isolates using the IS 6110 restriction fragment length polymorphism (RFLP) technique. Of the 3,093 cases identified from 1999-2001, 610 (~20%) were indigenous patients (average incidence: 377/100,000/year). The use of the O-K culture method increased the number of diagnosed cases by 34.1%. Of the genotyped isolates from 52 indigenous patients, 33 (63.5%) belonged to cluster RFLP patterns, indicating recently transmitted TB. These results demonstrate high, on-going TB transmission rates among the indigenous people of MS and indicate that new efforts are needed to disrupt these current transmissions.
Keywords
TuberculosisGenotyping
Microbiology
Molecular epidemiology
South American indigenous people
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