TY - JOUR
T1 - Phylogeography and transmission of Mycobacterium tuberculosis spanning prisons and surrounding communities in Paraguay
AU - Sanabria, Gladys Estigarribia
AU - Sequera, Guillermo
AU - Aguirre, Sarita
AU - M?ndez, Julieta
AU - dos Santos, Paulo C. sar Pereira
AU - Gustafson, Natalie Weiler
AU - Godoy, Margarita
AU - Ortiz, Anal?a
AU - Cespedes, Cynthia
AU - Mart?nez, Gloria
AU - Garc?a-Basteiro, Alberto L.
AU - Andrews, Jason R.
AU - Croda, Julio
AU - Walter, Katharine S.
N1 - Funding Information: The authors thank the following health staff who facilitated the field work laboratory analyses and clinical follow up: Ruth Martinez, Nestor Moreno, Natalia Sosa. We also would like to express our gratitude to Pilar Muñoz, Johana Monteserin, CEDIC, LCSP and the Penitentiary Health Department from the Ministry of Justice for its support and advice for this project. The study was supported by the grant PIN15-705 from National Commission of Science and Technology (CONACYT) of Paraguay (GES and GS) and National Institutes of Health grants R01 AI130058 (JRA) and R01 AI149620 (JRA and JC) and K01AI173385 (KSW). Funding Information: The authors thank the following health staff who facilitated the field work laboratory analyses and clinical follow up: Ruth Martinez, Nestor Moreno, Natalia Sosa. We also would like to express our gratitude to Pilar Muñoz, Johana Monteserin, CEDIC, LCSP and the Penitentiary Health Department from the Ministry of Justice for its support and advice for this project. The study was supported by the grant PIN15-705 from National Commission of Science and Technology (CONACYT) of Paraguay (GES and GS) and National Institutes of Health grants R01 AI130058 (JRA) and R01 AI149620 (JRA and JC) and K01AI173385 (KSW). Publisher Copyright: © 2023, The Author(s).
PY - 2023/1/19
Y1 - 2023/1/19
N2 - Recent rises in incident tuberculosis (TB) cases in Paraguay and the increasing concentration of TB within prisons highlight the urgency of targeting strategies to interrupt transmission and prevent new infections. However, whether specific cities or carceral institutions play a disproportionate role in transmission remains unknown. We conducted prospective genomic surveillance, sequencing 471 Mycobacterium tuberculosis complex genomes, from inside and outside prisons in Paraguay’s two largest urban areas, Asunción and Ciudad del Este, from 2016 to 2021. We found genomic evidence of frequent recent transmission within prisons and transmission linkages spanning prisons and surrounding populations. We identified a signal of frequent M. tuberculosis spread between urban areas and marked recent population size expansion of the three largest genomic transmission clusters. Together, our findings highlight the urgency of strengthening TB control programs to reduce transmission risk within prisons in Paraguay, where incidence was 70 times that outside prisons in 2021.
AB - Recent rises in incident tuberculosis (TB) cases in Paraguay and the increasing concentration of TB within prisons highlight the urgency of targeting strategies to interrupt transmission and prevent new infections. However, whether specific cities or carceral institutions play a disproportionate role in transmission remains unknown. We conducted prospective genomic surveillance, sequencing 471 Mycobacterium tuberculosis complex genomes, from inside and outside prisons in Paraguay’s two largest urban areas, Asunción and Ciudad del Este, from 2016 to 2021. We found genomic evidence of frequent recent transmission within prisons and transmission linkages spanning prisons and surrounding populations. We identified a signal of frequent M. tuberculosis spread between urban areas and marked recent population size expansion of the three largest genomic transmission clusters. Together, our findings highlight the urgency of strengthening TB control programs to reduce transmission risk within prisons in Paraguay, where incidence was 70 times that outside prisons in 2021.
UR - http://www.scopus.com/inward/record.url?scp=85146560757&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41467-023-35813-9
DO - https://doi.org/10.1038/s41467-023-35813-9
M3 - Article
C2 - 36658111
SN - 2041-1723
VL - 14
JO - Nature communications
JF - Nature communications
M1 - 303
ER -