ArticleBMC infectious diseases2019
A nationwide study of multidrug-resistant tuberculosis in Portugal 2014-2017 using epidemiological and molecular clustering analyses.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Global and regional trends in multidrug- or rifampicin-resistant tuberculosis, 2000-2024 with forecasts to 2030: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Tuberculosis in adult migrants in Europe: a TBnet consensus statement.The European respiratory journal · 2025Pooled it
- Hospital-Based Genomic Surveillance ofBiology · 2025Article
- Prevalence and epidemiological pattern of drug-resistant tuberculosis among migrant populations in Wenzhou City, China, 2014-2023: implications for public health strategies.Frontiers in public health · 2025Article
- Prevalence and epidemic pattern of ecdemic multidrug-resistant tuberculosis during 2012-2022 in Hangzhou, China: implication for public health strategies.BMC public health · 2024Article
- Intra-urban variation in tuberculosis and community socioeconomic deprivation in Lisbon metropolitan area: a Bayesian approach.Infectious diseases of poverty · 2022Article
- Clusters of Drug-Resistant Mycobacterium tuberculosis Detected by Whole-Genome Sequence Analysis of Nationwide Sample, Thailand, 2014-2017.Emerging infectious diseases · 2021Article
- Article
- Using Bayesian spatial models to map and to identify geographical hotspots of multidrug-resistant tuberculosis in Portugal between 2000 and 2016.Scientific reports · 2020Article
- Determinants of multidrug-resistant tuberculosis in São Paulo-Brazil: a multilevel Bayesian analysis of factors associated with individual, community and access to health services.Tropical medicine & international health : TM & IH · 2020Article
- Evolutionary analysis of Mycobacterium bovis genotypes across Africa suggests co-evolution with livestock and humans.PLoS neglected tropical diseases · 2020Article
- Using genomics to understand the origin and dispersion of multidrug and extensively drug resistant tuberculosis in Portugal.Scientific reports · 2020Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundIncreasing multidrug-resistant tuberculosis (MDR-TB) incidence is a major threat against TB eradication worldwide. We aim to conduct a detailed MDR-TB study in Portugal, an European country with endemic TB, combining genetic analysis and epidemiological data, in order to assess the efficiency of public health containment of MRD-TB in the country.
methodsWe used published MIRU-VNTR data, that we reanalysed using a phylogenetic analysis to better describe MDR-TB cases transmission occurring in Portugal from 2014 to 2017, further enriched with epidemiological data of these cases.
resultsWe show an MDR-TB transmission scenario, where MDR strains likely arose and are transmitted within local chains. 63% of strains were clustered, suggesting high primary transmission (estimated as 50% using MIRU-VNTR data and 15% considering epidemiological links). These values are higher than those observed across Europe and even for sensitive strains in Portugal using similar methodologies. MDR-TB cases are associated with individuals born in Portugal and evolutionary analysis suggests a local evolution of strains. Consistently the sublineage LAM, the most common in sensitive strains in Europe, is the more frequent in Portugal in contrast with the remaining European MDR-TB picture where immigrant-associated Beijing strains are more common.
conclusionsDespite efforts to track and contain MDR-TB strains in Portugal, their transmission patterns are still as uncontrolled as that of sensitive strains, stressing the need to reinforce surveillance and containment strategies.
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