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Molecular epidemiology of tuberculosis in the Midlands

Evans, Jason Thomas (2012)
Ph.D. thesis, University of Birmingham.

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Data from this thesis has extended our understanding of the molecular epidemiology and transmission of Mycobacterium tuberculosis in the Midlands. A novel DNA fingerprinting method called Mycobacterial Interspersed Repetitive Units containing Variable Number Tandem Repeats (MIRU-VNTR) typing provided equivalent results when compared to the current gold standard for DNA fingerprinting (IS6110 RFLP). To improve our understanding of TB in the Midlands, MIRU-VNTR typing was then developed to be assayed by non-dHPLC for the first time. Using this high-throughput rapid method a prospective and universal typing study was undertaken. This work identified the predominance of the Euro-American and East African Indian global clades in the Midlands and linked them to particular human population groups using novel software based on names. DNA fingerprinting also discovered the most prevalent single strain in the Midlands. This strain is geographically restricted to the West Midlands within the UK and globally. From this geographical association, we have called this strain the "Mercian" strain. The Mercian strain was not associated with patients who originated from the Indian Sub-Continent but was significantly associated with UK-born, Black Caribbean patients in Wolverhampton. These findings show that strains have been imported into the Midlands from around the world and there has also been continued transmission of these and other strains which may have been present in the Midlands for years. Molecular tools developed in this thesis will have regional, national, and international impact on TB control.

Type of Work:Ph.D. thesis.
Supervisor(s):Hawkey, Peter and Smith, Grace
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Immunity and Infection,
Subjects:QR Microbiology
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
ID Code:3416
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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