Infectious diseases are still causing high morbidity and mortality worldwide. For the last 13 years, I have been working in different projects studying human and insect pathogens. Tuberculosis (TB), a infectious disease caused by the human pathogen Mycobacterium tuberculosis, is one of the leading communicable diseases causing around 1.5 million deaths. According to the WHO, in 2017, an estimated 10.4 million people developed TB and 1.7million people died from TB, including 0.4 million among people with HIV.
M. tuberculosis is increasingly becoming resistant to all known anti-tuberculosis drugs (see Multidrug-resistant and extensively drug-resistant tuberculosis: a review of current concepts and future challenges. Clin Med 2014 Jun;14(3):279-85). Smear-microscopy (bacilloscopy) is a widely method to diagnose TB, however, its sensitivity ranges within 50-70%.
In Chiapas, a Mexican southern state, TB is a major public health concern. Diverse epidemiological studies have demonstrated that TB is still is the leading cause of morbidity and mortality. See the following studies which have investigated the TB epidemiological situation in diverse regions of Chiapas .
Multidrug-resistant pulmonary tuberculosis in Los Altos, Selva and Norte regions, Chiapas, Mexico.
Detection of pulmonary tuberculosis in Chiapas, Mexico.
Pulmonary tuberculosis and associated factors in areas of high levels of poverty in Chiapas, Mexico.
Pulmonary tuberculosis in the border region of Chiapas, Mexico.
Conceptions of tuberculosis and therapeutic choices in Highland Chiapas, Mexico.
A study has identified high mortality associated to pulmonary tuberculosis (PTB), the most infectious form of the disease, in the Highlands region (see The Poor Survival among PulmonaryTuberculosis Patients in Chiapas, Mexico: The Case of Los Altos Region. Tuberc. Res. Treat.). Additionally, in our more recent work in the same region, using geographic systems technology (GIS), we have identified municipalities with high and low incidence rates of TB per 100,000 inhabitants compared to national levels (see Spatial and temporal distribution of tuberculosis in the Highlands region of Chiapas, Mexico:preliminary results. The International Journal of Tuberculosis and Lung Diseases (The Union), 2014, Vol. 18, Number 11).
Notwithstanding the high burden of TB in Chiapas, nothing is known about genetic variation among M. tuberculosis strains circulating in the Highlands region of Chiapas. Genotyping M. tuberculosis will facilitate the detection of chains of transmission, identify contact tracing and source, analyze the risk factors associated with recent transmission, and measure the impact of TB control programs.