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Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa
Thesis (MSc)--Stellenbosch University, 2016
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2016
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| _version_ | 1867614030544240640 |
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| access_status_str | Open Access |
| author | Tshavhungwe, Phophi |
| author2 | Streicher, Elizabeth |
| author_browse | Streicher, Elizabeth Tshavhungwe, Phophi |
| author_facet | Streicher, Elizabeth Tshavhungwe, Phophi |
| author_sort | Tshavhungwe, Phophi |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MSc)--Stellenbosch University, 2016 |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/98292 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:45:33.890Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/98292 Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa Tshavhungwe, Phophi Streicher, Elizabeth Victor, Thomas Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Biomedical Sciences: Molecular Biology and Human Genetics Tuberculosis -- Patients -- South Africa Tuberculosis -- South Africa -- Western Cape UCTD Multidrug-resistant tuberculosis Molecular epidemiology Thesis (MSc)--Stellenbosch University, 2016 ENGLISH ABSTRACT : Tuberculosis is still to this day the most widespread infectious disease globally. The spread of drug-resistant strains which has been reported to be attributed to primary transmission threatens TB control and prevention programmes. Previous molecular epidemiological studies have reported that the dynamics of tuberculosis transmission varies geographically. The aim of the present study was to describe the drug-resistant tuberculosis epidemic and identify transmission hotspots and possible outbreaks of drug-resistant tuberculosis within the West Coast region of the Western Cape, South Africa. We used the internationally standardised spoligotyping method to classify Mycobacterium tuberculosis into different lineages and strain family and DNA sequencing of drug resistance conferring genes to genotypically characterise drug-resistant tuberculosis isolates collected from the West Coast region over a 5 year period (2008-2012). Spoligotyping data revealed the X-family as the most dominant M. tuberculosis strain family, followed by the Beijing family. Our findings are contradicting to what has been reported in the rest of the Western Cape Province that identified the Beijing family to be the predominant family responsible for drug-resistant tuberculosis within the province. We identified a cluster of multidrug-resistant isolates mainly located in the Northern parts of the region, harbouring similar spoligotyping patterns and identical mutations conferring resistance to the 4 first-line drugs used in tuberculosis treatment. This is indicative of transmission. Isolates belonging to this outbreak, but with different additional mutations conferring to resistance to second-line drugs were also identified, indicating that Pre-XDR and XDR-TB are primarily acquired on an existing MDR strain genotype. Even though spoligotyping is considered to have a low discriminatory power and could overestimate the extent of transmission, this study described an epidemic spread of multi-drug resistant strains in the West Coast region of the Western Cape. Our study highlighted the regional variation of outbreaks and the need for molecular epidemiology studies in various regions to tailor interventions to curb TB and drug-resistant TB spread. AFRIKAANSE OPSOMMING : Tuberkulose (TB) is steeds die mees wydverspreide aansteeklike siekte wêreldwyd. TB beheer en voorkomingsprogramme word bedreig deur middel-weerstandige TB wat ook wêreldwyd aangemeld word en meestal toegeskryf word aan primêre oordrag van die siekte tussen pasiënte. Vorige molekulêre epidemiologiese studies het gewys dat die dinamika van tuberkulose oordrag verskillend is in verskillende geografiese areas. Die doel van hierdie studie was om die middel-weerstandige tuberkulose epidemie in die Weskus distrik van die Wes-Kaap, Suid-Afrika te beskryf, en om potensiële uitbrake van middelweerstandige tuberkulose te identifiseer. Ons het gebruik gemaak van die internasionaal gestandaardiseerde spoligotipering metode om Mycobacterium tuberculosis in verskillende stamme en families te klassifiseer en DNA volgorde bepaling om mutasies wat middelweerstand veroorsaak te indentifiseer. Die studie is gedoen op isolate van TB pasiënte van die Weskus streek oor 'n tydperk van 5 jaar (2008-2012). Spoligotipering het gewys dat die X-familie as die mees dominante M. tuberculosis stamfamilie is, gevolg deur die Beijing stamfamilie. Ons bevindinge is teenstrydig teen wat voorheen giving is in the res van die Wes-Kaap Province, data die Beijing family oorheersend is en meestal verantwoordelik is vir middelweerstandige tuberkulose in die provinsie. Ons het verder 'n groep van multi-weerstandige isolate geïdentifiseer in die noordelike dele van die streek, met soortgelyke spoligotipering patrone en identiese mutasies wat weerstandigheid teen die 4 eerste linie middels veroorsaak. Dit is 'n aanduiding van oordrag van 'n multi-weerstandige stam familie in die streek. Isolate wat deel is van hierdie uitbraak, maar met verskillende bykomende mutasies wat weerstandigheid teen tweede linie middels het is ook geïdentifiseer, en dui daarop dat Ekstreem Weerstandige TB ontwikkel het deur mutasies wat later ontwikkel. Selfs al word spoligotipering beskou as 'n tegniek met minder diskriminerende waarde as ander ginotiperings tegnieke, en daarom die mate van tuberculose oordragf kan oorskat, bewys hierdie studie dat 'n multi-middelweerstandige epidemie versprei in die Weskus van die Wes-Kaap. Ons studie beklemtoon die noodsaaklikheid vir molekulêre epidemiologie studies in verskillende streke vir TB beheer en voorkomings programme om suksesvol te kan wees. 2016-03-09T14:01:38Z 2016-03-09T14:01:38Z 2016-03 Thesis http://hdl.handle.net/10019.1/98292 en_ZA Stellenbosch University xiv, 86 pages : illustrations, maps (chiefly colour) application/pdf application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Tuberculosis -- Patients -- South Africa Tuberculosis -- South Africa -- Western Cape UCTD Multidrug-resistant tuberculosis Molecular epidemiology Tshavhungwe, Phophi Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title | Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title_full | Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title_fullStr | Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title_full_unstemmed | Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title_short | Exploring drug-resistant tuberculosis profiles within the West Coast, South Africa |
| title_sort | exploring drug resistant tuberculosis profiles within the west coast south africa |
| topic | Tuberculosis -- Patients -- South Africa Tuberculosis -- South Africa -- Western Cape UCTD Multidrug-resistant tuberculosis Molecular epidemiology |
| url | http://hdl.handle.net/10019.1/98292 |
| work_keys_str_mv | AT tshavhungwephophi exploringdrugresistanttuberculosisprofileswithinthewestcoastsouthafrica |