Asare, P.Asante-Poku, A.Prah, D.A.Borrell, S.Osei-Wusu, S.Otchere, I.D.Forson, A.Adjapong, G.Koram, K.A.Gagneux, S.Yeboah-Manu, D.2019-02-042019-02-042018-08DOI: 10.1016/j.ijid.2018.05.014http://ugspace.ug.edu.gh/handle/123456789/27206Objective: Understanding transmission dynamics is useful for tuberculosis (TB) control. A population-based molecular epidemiological study was conducted to determine TB transmission in Ghana. Methods: Mycobacterium tuberculosis complex (MTBC) isolates obtained from prospectively sampled pulmonary TB patients between July 2012 and December 2015 were characterized using spoligotyping and standard 15-locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) typing for transmission studies. Results: Out of 2309 MTBC isolates, 1082 (46.9%) unique cases were identified, with 1227 (53.1%) isolates belonging to one of 276 clusters. The recent TB transmission rate was estimated to be 41.2%. Whereas TB strains of lineage 4 belonging to M. tuberculosis showed a high recent transmission rate (44.9%), reduced recent transmission rates were found for lineages of Mycobacterium africanum (lineage 5, 31.8%; lineage 6, 24.7%). Conclusions: The study findings indicate high recent TB transmission, suggesting the occurrence of unsuspected outbreaks in Ghana. The observed reduced transmission rate of M. africanum suggests other factor(s) (host/environmental) may be responsible for its continuous presence in West Africa. © 2018 The Author(s)enMIRU-VNTRMolecular epidemiologyMycobacterium africanumMycobacterium tuberculosisSpoligotypingTransmissionArticle