A systematic review of East African-Indian family of Mycobacterium tuberculosis in Brazil

Tonya Azevedo Duarte, Joilda Silva Nery, Neio Boechat, Susan Martins Pereira, Vera Simonsen, Martha Oliveira, Maria Gabriela Miranda Gomes, Carlos Penha-Gonçalves, Mauricio Lima Barreto, Theolis Barbosa

The Mycobacterium tuberculosis East African-Indian (EAI) spoligotyping family (belonging to lineage 1, Indo-Oceanic, defined by the region of deletion RD239) is distributed worldwide, but is more prevalent in Southeast Asia, India, and East Africa. Studies in Latin America have rarely identified EAI. In this study, we describe the occurrence of the EAI family in Brazil. EAI was identified in a systematic literature review of genetic diversity studies pertaining to M. tuberculosis in Brazil, as well as in a survey conducted in Salvador, Bahia, located in the northeastern region of this country. The EAI6-BGD1 spoligotyping family and the EAI5 SIT 1983 clade were the most frequently reported, with wide distribution of this particular clade described in Brazil. The distribution of other EAI spoligotyping patterns with broader worldwide distribution was restricted to the southeastern region of the country. EAI may be endemic at a low frequency in Brazil, with some clades indicating increased fitness with respect to this population.