ArticleThorax2013
Ethnicity and mycobacterial lineage as determinants of tuberculosis disease phenotype.
Article in Thorax, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed, 71 citations in OpenAlex.
- Extrapulmonary tuberculosis in The Netherlands, an epidemiologic overview, 1993-2022.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Spoligotyping-based molecular typing ofFrontiers in medicine · 2025Article
- Epidemiology ofFrontiers in veterinary science · 2025Article
- Relapse in ocular tuberculosis: relapse rate, risk factors and clinical management in a non-endemic country.The British journal of ophthalmology · 2024Article
- Integrated plasma proteomics identifies tuberculosis-specific diagnostic biomarkers.JCI insight · 2024Article
- Lack of methoxy-mycolates characterizes the geographically restricted lineage 7 ofMicrobial genomics · 2023Article
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- Cluster phenotypes in a non-idiopathic pulmonary fibrosis fibrotic interstitial lung diseases cohort in Singapore.Journal of thoracic disease · 2022Article
- Spoligotyping of Clinical Isolates ofFrontiers in public health · 2022Article
- Effect of mixed strain infections on clinical and epidemiological features of tuberculosis in Florida.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2021Article
- Epidemiology of Mycobacterium tuberculosis lineages and strain clustering within urban and peri-urban settings in Ethiopia.PloS one · 2021Article
- Molecular epidemiology of clinical Mycobacterium tuberculosis complex isolates in South Omo, Southern Ethiopia.BMC infectious diseases · 2020Article
- Article
- Host defense mechanisms against Mycobacterium tuberculosis.Cellular and molecular life sciences : CMLS · 2020Review
- Review
- Demographic risk factors for extra-pulmonary tuberculosis among adolescents and adults in Saudi Arabia.PloS one · 2019Article
- The Interplay of Human andFrontiers in genetics · 2019Review
- Article
- Mycobacterial Evolution Intersects With Host Tolerance.Frontiers in immunology · 2019Review
- Impact of Mycobacterium tuberculosis complex lineages as a determinant of disease phenotypes from an immigrant rich moderate tuberculosis burden country.Respiratory research · 2018Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEmerging evidence suggests that Mycobacterium tuberculosis (Mtb) lineage and host ethnicity can determine tuberculosis (TB) clinical disease patterns but their relative importance and interaction are unknown.
methodsWe evaluated prospectively collected TB surveillance and Mtb strain typing data in an ethnically heterogeneous UK population. Lineage assignment was denoted using 15-loci mycobacterial interspersed repetitive units containing variable numbers of tandem repeats (MIRU-VNTR) and MIRU-VNTRplus. Geographical and ethnic associations of the six global Mtb lineages were identified and the influence of lineage and demographic factors on clinical phenotype were assessed using multivariate logistic regression.
resultsData were available for 1070 individuals with active TB which was pulmonary only, extrapulmonary only and concurrent pulmonary-extrapulmonary in 52.1%, 36.9% and 11.0% respectively. The most prevalent lineages were Euro-American (43.7%), East African Indian (30.2%), Indo-Oceanic (13.6%) and East Asian (12.2%) and were geo-ethnically restricted with, for example, Indian subcontinent ethnicity inversely associated with Euro-American lineage (OR 0.23; 95% CI 0.14 to 0.39) and positively associated with the East African-Indian lineage (OR 4.04; 95% CI 2.19 to 7.45). Disease phenotype was most strongly associated with ethnicity (OR for extrathoracic disease 21.14 (95% CI 6.08 to 73.48) for Indian subcontinent and 14.05 (3.97 to 49.65) for Afro-Caribbean), after adjusting for lineage. With East Asian lineage as the reference category, the Euro-American (OR 0.54; 95% CI 0.32 to 0.91) and East-African Indian (OR 0.50; 95% CI 0.29 to 0.86) lineages were negatively associated with extrathoracic disease, compared with pulmonary disease, after adjusting for ethnicity.
conclusionsEthnicity is a powerful determinant of clinical TB phenotype independently of mycobacterial lineage and the role of ethnicity-associated factors in pathogenesis warrants investigation.
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