Evidence map›Paper›PMID 25673798›Full record

ArticleJournal of clinical microbiology2015

Mycobacterium tuberculosis lineage 7 strains are associated with prolonged patient delay in seeking treatment for pulmonary tuberculosis in Amhara Region, Ethiopia.

Solomon A Yimer, Gunnstein Norheim, Amine Namouchi, Ephrem D Zegeye, Wibeke Kinander, Tone Tønjum, Shiferaw Bekele, Turid Mannsåker, Gunnar Bjune, Abraham Aseffa and 1 more

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Article in Journal of clinical microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Solomon A YimerDepartment of Microbiology, Unit for Genome Dynamics, Oslo University Hospital, Nydalen, Oslo, Norway Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Division of Infectious Disease Control, Nydalen, Oslo, Norway Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway Amhara Regional State Health Bureau, Bahir Dar, Bahir Dar, Ethiopia s.a.yimer@medisin.uio.no.
Gunnstein NorheimDepartment of Bacteriology and Immunology, Norwegian Institute of Public Health, Division of Infectious Disease Control, Nydalen, Oslo, Norway.
Amine NamouchiDepartment of Microbiology, Unit for Genome Dynamics, Oslo University Hospital, Nydalen, Oslo, Norway.
Ephrem D ZegeyeDepartment of Microbiology, Unit for Genome Dynamics, Oslo University Hospital, Nydalen, Oslo, Norway.
Wibeke KinanderDepartment of Bacteriology and Immunology, Norwegian Institute of Public Health, Division of Infectious Disease Control, Nydalen, Oslo, Norway.
Tone TønjumDepartment of Microbiology, Unit for Genome Dynamics, Oslo University Hospital, Nydalen, Oslo, Norway Department of Microbiology, Unit for Genome Dynamics, University of Oslo, Oslo, Norway.
Shiferaw BekeleArmauer Hansen Research Institute, Addis Ababa, Ethiopia.
Turid MannsåkerDepartment of Bacteriology and Immunology, Norwegian Institute of Public Health, Division of Infectious Disease Control, Nydalen, Oslo, Norway.
Gunnar BjuneInstitute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway.
Abraham AseffaArmauer Hansen Research Institute, Addis Ababa, Ethiopia.
Carol Holm-HansenDepartment of Bacteriology and Immunology, Norwegian Institute of Public Health, Division of Infectious Disease Control, Nydalen, Oslo, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent genotyping studies of Mycobacterium tuberculosis in Ethiopia have reported the identification of a new phylogenetically distinct M. tuberculosis lineage, lineage 7. We therefore investigated the genetic diversity and association of specific M. tuberculosis lineages with sociodemographic and clinical parameters among pulmonary TB patients in the Amhara Region, Ethiopia. DNA was isolated from M. tuberculosis-positive sputum specimens (n=240) and analyzed by PCR and 24-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) analysis and spoligotyping. Bioinformatic analysis assigned the M. tuberculosis genotypes to global lineages, and associations between patient characteristics and genotype were evaluated using logistic regression analysis. The study revealed a high diversity of modern and premodern M. tuberculosis lineages, among which approximately 25% were not previously reported. Among the M. tuberculosis strains (n=138) assigned to seven subgroups, the largest cluster belonged to the lineage Central Asian (CAS) (n=60; 26.0%), the second largest to lineage 7 (n=36; 15.6%), and the third largest to the lineage Haarlem (n=35; 15.2%). Four sublineages were new in the MIRU-VNTRplus database, designated NW-ETH3, NW-ETH1, NW-ETH2, and NW-ETH4, which included 24 (10.4%), 18 (7.8%), 8 (3.5%), and 5 (2.2%) isolates, respectively. Notably, patient delay in seeking treatment was significantly longer among patients infected with lineage 7 strains (Mann-Whitney test, P<0.008) than in patients infected with CAS strains (adjusted odds ratio [AOR], 4.7; 95% confidence interval [CI], 1.6 to 13.5). Lineage 7 strains also grew more slowly than other M. tuberculosis strains. Cases of Haarlem (OR, 2.8; 95% CI, 1.2 to 6.6) and NW-ETH3 (OR, 2.8; 95% CI, 1.0 to 7.3) infection appeared in defined clusters. Intensified active case finding and contact tracing activities in the study region are needed to expedite diagnosis and treatment of TB.

Indexed as

Delayed DiagnosisGenotypeAdultCross-Sectional StudiesDNA, BacterialEthiopiaFemaleGenetic VariationHumansMaleMolecular EpidemiologyMolecular TypingMycobacterium tuberculosisSputumTuberculosis, PulmonaryVirulenceDNA, Bacterial

Identifiers

PMID25673798
PMCPMC4365194

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.