Daniel Mekonnen^{1, 2*,} Awoke Derbie^1,3, Andargachew Abeje⁴, Abebe Shumet⁵, Yonas Kassahun⁶, Endalkachew Nibret^2,7, Abaineh Munshae^2,7, Kidist Bobosha⁶, Liya Wassie⁶, Fantahun Biadglegne¹, Stefan Berg⁸, Abraham Aseffa⁶, Ulrich Sack⁹

¹Department of Medical Microbiology Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia.²Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia. ³The Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Ethiopia^{. 4}Geospatial data and Technology center, Bahir Dar University, Bahir Dar Ethiopia.

⁵Amhara Regional State Health Bureau, Felege Hiwot Referal Hospital, Bahir Dar, Ethiopia. ⁶Armauer Hansen Research Institute, Addis Ababa, Ethiopia.⁷Department of Biology, Bahir Dar University, Bahir Dar, Ethiopia.⁸Animal and Plant Health Agency, the United Kingdom.⁹Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany

*Corresponding Author: nigusdaniel@gmail.com

Abstract

Introduction: The population genomic make-up of Mycobacterium tuberculosis complex (MTBC) is geographically restricted. This review determined the phylogeography, clinical phenotype related genomic diversity and transmission dynamics of MTBC in Africa.

Methods: Spoligotyping and MIRU-VNTR based articles were analyzed. Articles published in English language irrespective of year of publication were included. We retrieved articles from PubMed and Scopus on 12 May 2018. Phylogeographic distributions was scrutinized using ArcGIS 10.3. Clustering and recent transmission index (RTI) were figured out using Stata 14.

Results: Among the MTBC population genomic make-up, 92% and 7% went to M. tuberculosis and M. africanum, respectively. The minority (1%) went to the animal habituated species of Mycobacterium. Of the lineages under M. tuberculosis, the Euro-American (EA) and Central Asia (CAS) gauged at 67% and 10%, respectively. Lineage 7 and M. africanum were confined in Ethiopia and western Africa, correspondgly. The EA sub-lineages such as T3-Ethiopia_2, H37Rv, Haarlem (H) and H3-Ural were proportionally higher among tuberculous lymphadenitis (TBLN) compared with pulmonary tuberculosis (PTB). The pooled prevalence of clustering and RTI was 48% and 35%, respectively. Moreover, the rate of clustering was higher among PTB (52%) compared with TBLN (31%).

Conclusions: Africa in general and east-west pole of Africa in particular harbored diverse population genomic make-up of MTBC. While EA lineage remains the prominent lineage; M. bovis is going away as a cause of human TB. The high prevalence report of active TB transmission marked the awful TB control program. Hence, key policy priority should be breaking the transmission, promoting innovative approach for early case notification and contact tracing.

Key words: Molecular epidemiology, M. tuberculosis, Africa