Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis

<h4>Background</h4> <p>The host, microbial, and environmental factors that contribute to variation in tuberculosis (TB) disease are incompletely understood. Accumulating evidence suggests that one driver of geographic variation in TB disease is the local ecology of mycobacterial g...

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Main Authors: Wiens, KE, Woyczynski, LP, Ledesma, JR, Ross, JM, Zenteno-Cuevas, R, Goodridge, A, Ullah, I, Mathema, B, Siawaya, JF, Biehl, MH, Ray, SE, Bhattacharjee, NV, Henry, NJ, Reiner, RC, Kyu, HH, Murray, CJL, Hay, SI
Format: Journal article
Language:English
Published: BioMed Central 2018
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author Wiens, KE
Woyczynski, LP
Ledesma, JR
Ross, JM
Zenteno-Cuevas, R
Goodridge, A
Ullah, I
Mathema, B
Siawaya, JF
Biehl, MH
Ray, SE
Bhattacharjee, NV
Henry, NJ
Reiner, RC
Kyu, HH
Murray, CJL
Hay, SI
author_facet Wiens, KE
Woyczynski, LP
Ledesma, JR
Ross, JM
Zenteno-Cuevas, R
Goodridge, A
Ullah, I
Mathema, B
Siawaya, JF
Biehl, MH
Ray, SE
Bhattacharjee, NV
Henry, NJ
Reiner, RC
Kyu, HH
Murray, CJL
Hay, SI
author_sort Wiens, KE
collection OXFORD
description <h4>Background</h4> <p>The host, microbial, and environmental factors that contribute to variation in tuberculosis (TB) disease are incompletely understood. Accumulating evidence suggests that one driver of geographic variation in TB disease is the local ecology of mycobacterial genotypes or strains, and there is a need for a comprehensive and systematic synthesis of these data. The objectives of this study were to (1) map the global distribution of genotypes that cause TB disease and (2) examine whether any epidemiologically relevant clinical characteristics were associated with those genotypes.</p> <h4>Methods</h4> <p>We performed a systematic review of PubMed and Scopus to create a comprehensive dataset of human TB molecular epidemiology studies that used representative sampling techniques. The methods were developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We extracted and synthesized data from studies that reported prevalence of bacterial genotypes and from studies that reported clinical characteristics associated with those genotypes.</p> <h4>Results</h4> <p>The results of this study are twofold. First, we identified 206 studies for inclusion in the study, representing over 200,000 bacterial isolates collected over 27 years in 85 countries. We mapped the genotypes and found that, consistent with previously published maps, Euro-American lineage 4 and East Asian lineage 2 strains are widespread, and West African lineages 5 and 6 strains are geographically restricted. Second, 30 studies also reported transmission chains and 4 reported treatment failure associated with genotypes. We performed a meta-analysis and found substantial heterogeneity across studies. However, based on the data available, we found that lineage 2 strains may be associated with increased risk of transmission chains, while lineages 5 and 6 strains may be associated with reduced risk, compared with lineage 4 strains.</p> <h4>Conclusions</h4> <p>This study provides the most comprehensive systematic analysis of the evidence for diversity in bacterial strains that cause TB disease. The results show both geographic and epidemiological differences between strains, which could inform our understanding of the global burden of TB. Our findings also highlight the challenges of collecting the clinical data required to inform TB diagnosis and treatment. We urge future national TB programs and research efforts to prioritize and reinforce clinical data collection in study designs and results dissemination.</p>
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spelling oxford-uuid:0ea3ac57-9060-42db-b87c-3ef05e4a4d992022-03-26T09:47:00ZGlobal variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0ea3ac57-9060-42db-b87c-3ef05e4a4d99EnglishSymplectic Elements at OxfordBioMed Central2018Wiens, KEWoyczynski, LPLedesma, JRRoss, JMZenteno-Cuevas, RGoodridge, AUllah, IMathema, BSiawaya, JFBiehl, MHRay, SEBhattacharjee, NVHenry, NJReiner, RCKyu, HHMurray, CJLHay, SI <h4>Background</h4> <p>The host, microbial, and environmental factors that contribute to variation in tuberculosis (TB) disease are incompletely understood. Accumulating evidence suggests that one driver of geographic variation in TB disease is the local ecology of mycobacterial genotypes or strains, and there is a need for a comprehensive and systematic synthesis of these data. The objectives of this study were to (1) map the global distribution of genotypes that cause TB disease and (2) examine whether any epidemiologically relevant clinical characteristics were associated with those genotypes.</p> <h4>Methods</h4> <p>We performed a systematic review of PubMed and Scopus to create a comprehensive dataset of human TB molecular epidemiology studies that used representative sampling techniques. The methods were developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We extracted and synthesized data from studies that reported prevalence of bacterial genotypes and from studies that reported clinical characteristics associated with those genotypes.</p> <h4>Results</h4> <p>The results of this study are twofold. First, we identified 206 studies for inclusion in the study, representing over 200,000 bacterial isolates collected over 27 years in 85 countries. We mapped the genotypes and found that, consistent with previously published maps, Euro-American lineage 4 and East Asian lineage 2 strains are widespread, and West African lineages 5 and 6 strains are geographically restricted. Second, 30 studies also reported transmission chains and 4 reported treatment failure associated with genotypes. We performed a meta-analysis and found substantial heterogeneity across studies. However, based on the data available, we found that lineage 2 strains may be associated with increased risk of transmission chains, while lineages 5 and 6 strains may be associated with reduced risk, compared with lineage 4 strains.</p> <h4>Conclusions</h4> <p>This study provides the most comprehensive systematic analysis of the evidence for diversity in bacterial strains that cause TB disease. The results show both geographic and epidemiological differences between strains, which could inform our understanding of the global burden of TB. Our findings also highlight the challenges of collecting the clinical data required to inform TB diagnosis and treatment. We urge future national TB programs and research efforts to prioritize and reinforce clinical data collection in study designs and results dissemination.</p>
spellingShingle Wiens, KE
Woyczynski, LP
Ledesma, JR
Ross, JM
Zenteno-Cuevas, R
Goodridge, A
Ullah, I
Mathema, B
Siawaya, JF
Biehl, MH
Ray, SE
Bhattacharjee, NV
Henry, NJ
Reiner, RC
Kyu, HH
Murray, CJL
Hay, SI
Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title_full Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title_fullStr Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title_full_unstemmed Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title_short Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis
title_sort global variation in bacterial strains that cause tuberculosis disease a systematic review and meta analysis
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