Heterogeneity of Mycobacterium tuberculosis Strains Circulating in Panama’s Western Region

Author:

Acosta Fermin1,Saldaña Ricardo2,Miranda Sara13,Candanedo Daniela1,Sambrano Dilcia1,Morán Mitchelle1,Bejarano Saily2,De Arriba Yeraldine2,Reigosa Angel2,De Dixon Elizabeth2,Atencio María2,Castillo Ramón4,Goodridge Amador1

Affiliation:

1. Tuberculosis Biomarker Research Unit at Centro de Biologia Celular y Molecular de Enfermedades (CBCME) Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), City of Knowledge, Panama City, Panama;

2. Hospital Materno Infantil José Domingo de Obaldía, David City, Provincia de Chiriquí, Panama;

3. Universidad Autónoma de Chiriqui (UNACHI), David City, Provincia de Chiriquí, Panama;

4. Programa Regional de Tuberculosis de la Provincia de Chiriquí, Ministerio de Salud, David City, Provincia de Chiriquí, Panama

Abstract

ABSTRACT. Tuberculosis remains a challenge in both rural and urban areas. Although a majority of countries display a higher burden in urban areas compared with rural areas, Panama continues to report the highest mortality rate in Central America. Urban areas, such as Panama City, report a high tuberculosis burden, whereas Panama’s western region, including the provinces of Chiriquí, Bocas del Toro (both semiurban) and Ngäbe-Bugle (rural), show a lower burden. We aimed to identify highly transmitted Mycobacterium tuberculosis strains within rural and semiurban settings of Panama’s western region during a 3-year period (2017, 2019, 2021). We randomly selected 87 M. tuberculosis isolates from a biobank from Panama’s western region and analyzed them using allele-specific oligonucleotide polymerase chain reaction and 24-mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). Our results show only 11.7% (10/85) of M. tuberculosis strains identified as prevalent A-Beijing, B-Haarlem, or C-LAM Strains. We found a low prevalence of A, B, and C M. tuberculosis strains in both rural and semirural settings compared with isolates collected from the Eastern Colon Province. MIRU-VNTR genotyping revealed a high degree of diversity with no clusters with single loci variation of ≥ 2 loci. These results support the notion that tuberculosis prevalence in the rural and semiurban western region of Panama are not due to previously described highly transmitted strains but is influenced instead by other health determinants, including poor health system access and a lack of systematic transmission chain monitoring. For remote rural and semiurban settings, we recommend allocating resources to reinforce efforts to prevent tuberculosis spread.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

Reference29 articles.

1. Tuberculosis remains a challenge despite economic growth in Panama;Tarajia,2014

2. Geographic accessibility, readiness, and barriers of health facilities to offer tuberculosis services in East Gojjam Zone, Ethiopia: a convergent parallel design;Asemahagn,2020

3. Characterizing tuberculosis transmission dynamics in high-burden urban and rural settings;Smith,2022

4. Urban-rural disparities in treatment outcomes among recurrent TB cases in Southern Province, Zambia;Mutembo,2019

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