Association of Mycobacterium africanum Infection with Slower Disease Progression Compared with Mycobacterium tuberculosis in Malian Patients with Tuberculosis

Bocar Baya*, Bassirou Diarra, Seydou Diabate, Bourahima Kone, Drissa Goita, Yeya dit Sadio Sarro, Keira Cohen, Jane Louise Holl, Chad J. Achenbach, Mohamed Tolofoudie, Antieme Combo Georges Togo, Moumine Sanogo, Amadou Kone, Ousmane Kodio, Djeneba Dabitao, Nadie Coulibaly, Sophia Siddiqui, Samba Diop, William Bishai, Sounkalo DaoSeydou Doumbia, Robert Leo Murphy, Souleymane Diallo, Mamoudou Maiga

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Mycobacterium africanum (MAF) is known to endemically cause up to 40-50% of all pulmonary TB in West Africa. The aim of this study was to compare MAF with Mycobacterium tuberculosis (MTB) with regard to time from symptom onset to TB diagnosis, and clinical and radiological characteristics. A cross-sectional study was conducted in Bamako, Mali, between August 2014 and July 2016. Seventy-seven newly diagnosed pulmonary TB patients who were naive to treatment were enrolled at Mali's University Clinical Research Center. Sputum cultures were performed to confirm the diagnosis and spoligotyping to identify the mycobacterial strain. Univariate and multivariate analyses were used to identify factors associated with disease progression. Overall, the frequency of female patients was 25% in MAF infection and only 10.0% in MTB infection (OR = 2.9), and MAF was more represented in patients aged 3 30 years (57.1% versus 36.7% [OR = 2.3]). More MAF- than MTB-infected patients had a history of a prior TB contact (32.1% versus 14.3% [OR = 2.8]). The mean duration between cough onset and TB diagnosis was 111 days (∼3.7 months) for MAF and 72 days (∼2.4 months) for MTB (P = 0.007). In a multivariate regression, weight loss (body mass index [BMI] < 18.5 kg/m2) and cough duration (> 4 months) were strongly associated with MAF infection (OR = 5.20 [1.49-18.26], P = 0.010, and 4.74 [1.2-18.58], P = 0.02), respectively. Our data show that MAF infection was significantly associated with lower BMI and a longer time between symptom onset and TB diagnosis than MTB. This supports the concept that MAF infection may have slower disease progression and less severe cough symptoms than MTB.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume102
Issue number1
DOIs
StatePublished - Jan 1 2020

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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    Baya, B., Diarra, B., Diabate, S., Kone, B., Goita, D., Sarro, Y. D. S., Cohen, K., Holl, J. L., Achenbach, C. J., Tolofoudie, M., Togo, A. C. G., Sanogo, M., Kone, A., Kodio, O., Dabitao, D., Coulibaly, N., Siddiqui, S., Diop, S., Bishai, W., ... Maiga, M. (2020). Association of Mycobacterium africanum Infection with Slower Disease Progression Compared with Mycobacterium tuberculosis in Malian Patients with Tuberculosis. American Journal of Tropical Medicine and Hygiene, 102(1), 36-41. https://doi.org/10.4269/ajtmh.19-0264