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1. Characterisation and antimicrobial susceptibility pattern of non-tuberculous mycobacteria

Author

Abraham J. le Roux, Anneke van der Spoel van Dijk, and Motlatji R.B. Maloba

Subjects
non-tuberculous mycobacteria, mycobacteria avium complex, mycobacterium abscessus, genotype® ntm-dr, genotypic antimicrobial susceptibility., Infectious and parasitic diseases, RC109-216
Abstract

Background: Non-tuberculous mycobacteria (NTM) management comprises prolonged therapy that includes macrolides. Non-tuberculous mycobacteria can cause disease in patients with predisposing conditions such as HIV and structural lung disease. Local data on NTM disease and macrolide resistance are scarce, and routine antimicrobial susceptibility testing is currently not performed for NTM in South Africa. Objectives: This study aims to characterise NTM isolated at Tshepong National Health Laboratory Service (NHLS) according to species and antimicrobial susceptibility pattern. Method: A retrospective data analysis of NTM isolates from Tshepong NHLS was performed from January to June 2020. GenoType® NTM-DR was performed on selected isolates where the assay can confirm the species and determine resistance to macrolides and aminoglycosides. Results: Of the 194 collected NTM isolates, 183 were included in the study. Patients’ ages ranged from 1 day to 81 years (median 36 years). The most common specimen was sputum (84.7%), followed by gastric aspirate (6.6%). The most common NTM isolated were Mycobacterium (M.) intracellulare (67.6%), M. fortuitum (12.6%), M. species (4.3%), M. kansasii (3.9%), and M. scrofulaceum (3.9%). Macrolide resistance occurred in 2.8% of tested isolates; no aminoglycoside resistance was detected. Although most isolates were from males (62.3%), resistance was observed only in females. Conclusion: M. intracellulare predominated, with only two M. intracellulare and two M. abscessus isolates showing macrolide resistance; aminoglycoside resistance was absent. Contribution: This study highlights the need for increased awareness of NTM, regular nationwide NTM surveillance, and monitoring of resistance trends to guide future patient management and ensure good treatment outcomes.

Published
2024
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4. Diverse Molecular Genotypes of Mycobacterium tuberculosis Complex Isolates Circulating in the Free State, South Africa

Author

Anneke Van der Spoel van Dijk, Pakiso M. Makhoahle, Leen Rigouts, and Kamaldeen Baba

Subjects
Microbiology, QR1-502
Abstract

Tuberculosis is a serious public health concern especially in Africa and Asia. Studies describing strain diversity are lacking in the Free State region of South Africa. The aim of the study was to describe the diversity of Mycobacterium tuberculosis (M. tuberculosis) strain families in the Free State province of South Africa. A total of 86 M. tuberculosis isolates were genotyped using spoligotyping. A 12-locus mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTRs) typing was used to further characterize the resulting spoligotyping clusters. SITVITWEB identified 49 different patterns with allocation to six lineages including Latin-American-Mediterranean (LAM) (18 isolates), T (14 isolates), Beijing (five isolates), S (six isolates), Haarlem (one isolate), and X (five isolates), while 37 (43.0%) orphans were identified. Eight clusters included 37 isolates with identical spoligotypes (2 to 13/cluster). MIRU-VNTR typing further differentiated three spoligotyping clusters: SIT1/Beijing/MIT17, SIT33/LAM3/MIT213, and confirmed one SIT34/S/MIT311. In addition, SpolDB3/RIM assignment of the orphan strains resulted in a further 10 LAM and 13 T families. In total, LAM (28 isolates) and T (27 isolates) cause 63% of the individual cases of MTB in our study. The Free State has a highly diverse TB population with LAM being predominant. Further studies with inclusion of multidrug-resistant strains with larger sample size are warranted.

Published
2016
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5. High strain diversity among isoniazid-resistant M tuberculosis isolates from the Free State and Northern Cape provinces

Author

Zac Mokhethi, Anneke van der Spoel-van Dijk, Adri van der Zanden, and Leen Rigouts

Subjects
History of scholarship and learning. The humanities, AZ20-999, Political science
Abstract

This study set out to determine the diversity of the isoniazid-resistant M tuberculosis isolates causing pulmonary tuberculosis in the Free State and Northern Cape provinces of South Africa. Thirty-seven isoniazid-resistant isolates from a nation-wide survey could be fingerprinted by IS6110-based RFLP. Spoligotyping and MIRU-VNTR typing were performed to confirm inconclusive results. The number of IS6110 copies per isolate varied from 2 to 18, with nine (24.3%) isolates harbouring five insertions or fewer. Nine (24.3%) of 37 cases grouped into four RFLP-clusters. The clustered isolates with fewer than five IS6110 copies were all shown to be different when subjected to spoligotyping and MIRU-VNTR typing, whereas the clustering of the high-copy isolates was confirmed. The high degree of diversity among H-resistant isolates in the Free State suggests a low recent transmission rate, but this should be investigated by long-term analyses. For the Northern Cape province, representative sampling is needed before proper conclusions can be drawn.

Published
2005

6. DNA fingerprinting analyses of M tuberculosis-complex isolates from the Free State, South Africa, as part of a multidisciplinary study

Author

Anneke van der Spoel-van Dijk, Zac Mokhethi, Macala Khumalo, Choala Shamputa, Zacheus Matebesi, Dingie van Rensburg, Francoise Portaels, and Leen Rigouts

Subjects
History of scholarship and learning. The humanities, AZ20-999, Political science
Abstract

The objective of this study was to serve as a complement to socio-economic analyses of TB patients in a DOTS system, providing microbiological data and documenting the TB population dynamics. Sputum samples were collected from smear-positive TB patients in the Goldfields, Thaba Nchu and Qwaqwa areas. Laboratory analyses comprised the culturing of Mycobacterium tuberculosis isolates and DNA fingerprinting. The primary aim was hampered by problems encountered during specimen sampling, inadequate resources, and a low culture-positivity rate. Nevertheless, the fingerprinting data of a random sample showed a heterogenous TB population, suggesting that reactivation might be an important factor in the area studied. Clustering was the highest in the mining area. Preliminary data from serial isolates also detected possible re-infection during treatment or initial mixed infections in five of the eleven patients.

Published
2005

7. Prevalence of isoniazid resistance-conferring mutations associated with multidrug-resistant tuberculosis in Free State Province, South Africa

Author

A. Van der Spoel van Dijk, L Pitso, and Samantha Potgieter

Subjects
0301 basic medicine, Adult, Male, Tuberculosis, Adolescent, Extensively Drug-Resistant Tuberculosis, 030106 microbiology, 030231 tropical medicine, Antitubercular Agents, Drug resistance, Microbial Sensitivity Tests, Gene mutation, Mycobacterium tuberculosis, 03 medical and health sciences, chemistry.chemical_compound, South Africa, Young Adult, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, Tuberculosis, Multidrug-Resistant, Isoniazid, Prevalence, Medicine, Humans, Child, Aged, Retrospective Studies, Aged, 80 and over, biology, business.industry, INHA, Infant, General Medicine, biochemical phenomena, metabolism, and nutrition, Middle Aged, medicine.disease, biology.organism_classification, bacterial infections and mycoses, Virology, chemistry, Child, Preschool, Mutation, Ethionamide, Female, Bedaquiline, business, medicine.drug
Abstract

Background. Multidrug- and extensively drug-resistant tuberculosis (MDR-TB and XDR- TB) threaten local and global control of the disease. The molecular line-probe assay (LPA) provides rapid diagnosis and early management of MDR-TB. The LPA detects mutations of katG and inhA genes associated with isoniazid (INH) resistance in Mycobacterium tuberculosis isolates. The katG and inhA genes are associated with high- and low-level INH resistance, respectively, as well as cross-resistance to ethionamide in the case of inhA gene mutations. Patients with MDR-TB due to an inhA mutation could benefit from the use of high-dose INH – instead of ethionamide – in their MDR-TB regimen. Objectives. To determine the frequencies of katG and inhA mutations that conferred INH resistance among MDR-TB isolates during 2014 - 2016 in Free State (FS) Province of South Africa. Methods. We retrospectively reviewed MDR-TB isolates assayed with GenoType MTBDR plus (Hain Lifescience, Germany) (LPA) at the central TB laboratory of Universitas Academic Hospital, Bloemfontein, FS, and calculated the frequencies of katG and inhA mutations. Results. Among 918 MDR-TB isolates, the prevalence of katG , inhA and katG plus inhA mutations was 63.9%, 13.4% and 22.7%, respectively. Approximately 60% ( n =536; 58.4%) of the isolates were obtained from male patients. The patients’ ages ranged from 1 to 89 (median 37) years. The Xhariep district had the highest incidence of INH resistance-conferring mutations in the province. Conclusions. katG -associated mutations are the predominant INH resistance-conferring mechanism among MDR-TB isolates in the FS. Patients infected with isolates that harbour the katG mutation are unlikely to benefit from high-dose INH therapy in the bedaquiline (BDQ)-containing modified short MDR-TB regimen. They may, however, benefit from the inclusion of ethionamide in the regimen. Dual katG and inhA gene mutations make these patients unlikely to respond to either high-dose INH or ethionamide and should now be considered for either the BDQ-containing long MDR-TB regimen or an individualised treatment regimen, depending on fluoroquinolone susceptibility. Clinicians should familiarise themselves with interpreting various INH resistance-conferring mutation results and their implications for management of MDR-TB treatment.

Published
2019

12. Comparison of methods and samples used in the diagnosis of childhood PTB and characterization of mycobacterium tuberculosis isolates

Author

Ogunbayo, Ayodeji Emmanuel, Van der Spoel van Dijk, Anneke, Bulane, Atang, Ogunbayo, Ayodeji Emmanuel, Van der Spoel van Dijk, Anneke, and Bulane, Atang

Abstract

The diagnosis of childhood pulmonary tuberculosis (PTB) remains an ongoing challenge due to the atypical clinical presentations of the disease. Bacteriological confirmation of PTB and drug susceptibility testing (DST) is imperative in an era of increasing drug resistance, but is seldom achieved in children. This is due to the challenges in obtaining adequate specimens and the low sensitivity of currently available microbiological tests owing to the paucibacillary nature of TB in children as well co-infection with human immunodeficiency virus. The difficulty in obtaining spontaneously expectorated sputum has necessitated the use of induced sputum or gastric aspirate (GA), which both requires infrastructure and technical expertise. To promote decentralisation and enhance the acceptance of routine specimen collection in children, feasible alternatives (such as stool, urine, and nasopharyngeal specimens) have been proposed. However, operational data on the performance and diagnostic yield of these specimens requires further study. Furthermore, the occurrence and transmission of Mycobacterium tuberculosis (M. tuberculosis) strain families varies by regions and has not yet been documented in children from the Free State. Moreover, since disease progression in children after primary infection mostly occurs within 12 months, genotypic analysis of isolates from children could indicate current transmission patterns of M. tuberculosis in a community. This study aimed to determine and compare the diagnostic yield of various samples [Nasopharyngeal aspirate (NPA), Nasopharyngeal swab (NPS), GA, urine and stool] and methods [smear microscopy, culture and GeneXpert® MTB/RIF (Xpert®)] used in the diagnosis of childhood PTB. Our study further characterise the TB positive isolates with regard to drug resistance using the BACTEC™ MGIT™ 960 System and Genotype® MTBDRplus, and strain diversity using spoligotyping and a 24 loci Mycobacterial Interspersed Repetitive Units-Variable Number, National Research Foundation (NRF), NHLS Research Trust

Published
2018

13. Diverse Molecular Genotypes of Mycobacterium tuberculosis Complex Isolates Circulating in the Free State, South Africa

Author

Kamaldeen Baba, Anneke Van der Spoel-van Dijk, Leen Rigouts, and Pakiso M. Makhoahle

Subjects
0301 basic medicine, Microbiology (medical), education.field_of_study, Tuberculosis, Article Subject, biology, Molecular epidemiology, 030106 microbiology, Population, biology.organism_classification, medicine.disease, Microbiology, Virology, QR1-502, Mycobacterium tuberculosis, 03 medical and health sciences, Mycobacterium tuberculosis complex, Genotype, medicine, Typing, education, Genotyping, Research Article
Abstract

Tuberculosis is a serious public health concern especially in Africa and Asia. Studies describing strain diversity are lacking in the Free State region of South Africa. The aim of the study was to describe the diversity ofMycobacterium tuberculosis(M. tuberculosis) strain families in the Free State province of South Africa. A total of 86M. tuberculosisisolates were genotyped using spoligotyping. A 12-locus mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTRs) typing was used to further characterize the resulting spoligotyping clusters. SITVITWEB identified 49 different patterns with allocation to six lineages including Latin-American-Mediterranean (LAM) (18 isolates), T (14 isolates), Beijing (five isolates), S (six isolates), Haarlem (one isolate), and X (five isolates), while 37 (43.0%) orphans were identified. Eight clusters included 37 isolates with identical spoligotypes (2 to 13/cluster). MIRU-VNTR typing further differentiated three spoligotyping clusters: SIT1/Beijing/MIT17, SIT33/LAM3/MIT213, and confirmed one SIT34/S/MIT311. In addition, SpolDB3/RIM assignment of the orphan strains resulted in a further 10 LAM and 13 T families. In total, LAM (28 isolates) and T (27 isolates) cause 63% of the individual cases of MTB in our study. The Free State has a highly diverse TB population with LAM being predominant. Further studies with inclusion of multidrug-resistant strains with larger sample size are warranted.

Published
2015

16. The diagnosis of skeletal tuberculosis by polymerase chain reaction

Author

P L Botha, C A Beukes, A. Van der Spoel van Dijk, M A Kapnoudhis, J A Shipley, and A MCleod

Subjects
medicine.medical_specialty, Pathology, Tuberculosis, Biopsy, Polymerase Chain Reaction, Sensitivity and Specificity, Tuberculosis, Osteoarticular, law.invention, Mycobacterium tuberculosis, Medical microbiology, law, Positive predicative value, medicine, Humans, Polymerase chain reaction, Bacteriological Techniques, biology, business.industry, Anatomical pathology, Histology, General Medicine, medicine.disease, biology.organism_classification, Cross-Sectional Studies, Ziehl–Neelsen stain, Spinal Diseases, business
Abstract

Objective To determine the potential of the polymerase chain reaction (PCR) for detecting Mycobacterium tuberculosis in skeletal samples by comparing results obtained by 1) Ziehl Neelsen staining, Lowenstein-Jensen and Bactec culture, 2) histopathology and clinical findings at the level of agreement, sensitivity and specificity. Design Cross sectional study. Setting Department of Medical Microbiology, Orthopaedics and Anatomical pathology, University of the Orange Free State Bloemfontein, South Africa. Subjects 45 consecutive patients were extensively investigated, 30 patients with clinical presumptive active tuberculosis and 15 with other pathology. Results Detection using culture could confirm only three of the 26 clinically diagnosed tuberculosis cases while PCR detection confirmed disease in 15 cases. The use of PCR increased the confirmation of clinically probable tuberculosis from 14 using standard laboratory techniques and histology to 18 of 26 cases. Calculated sensitivity and specificity for PCR employing culture as the "gold standard" were 100% (with 95% CI 29.2; 100.0) and 71.4% (55.4; 84.3), which due to low detection levels, basically excludes culture as a standard for statistical analysis. Sensitivity and specificity for PCR using histology as the "gold standard" were 78.6% (49.2; 95.3) and 87.1% (70.2; 96.4) respectively with positive and negative predictive values of 73.3% (44.9; 92.2) and 90% (73.5; 97.9) respectively. Positive agreement between PCR and histology was 0.64 (0.4; 0.9) indicating fair agreement. Conclusion Although numbers in the study were too low to effectively draw statistically valid conclusions the importance of the relevance of PCR for rapid detection of low numbers of acid-fast bacilli and confirmation of mycobacterial infection in spinal biopsies has been established.

Published
2000
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18. Historic origin of Mycobacterium tuberculosis complex strains in the Free State Province, South Africa

Author

Makhoahle, Pakiso Moses, Van der Spoel van Dijk, Anneke, Rigauts, Leen, Makhoahle, Pakiso Moses, Van der Spoel van Dijk, Anneke, and Rigauts, Leen

Abstract

With TB still a major threat worldwide and South Africa (SA) being one of the countries with the highest TB incidence, the development in the field of epidemiology gained importance to elucidate the history and dynamics of the disease. The aim of the study was to elucidate the diversity and historic origin of Mycobacterium tuberculosis (MTB) strains in the FS by studying the molecular epidemiology of isolates in three high burden areas. During 2001-2003 MTB isolates were collected during two studies in the FS from consenting patients and DNA from these isolates was further investigated in this study. It involved the use of molecular methods such as spoligotyping and 12MIRU-VNTR typing that provides unique patterns for different highly transmissible genotypes, permitting historic relationships and the origin of circulating strains to be deciphered and to make predictions concerning their spread. Multiplex PCR was used to further characterise the Beijing lineage types and complex software packages including the SpolDB3 and 4, Excell 2007 and MIRU-VNTRplus (to draw phylogenetic trees) aided the analysis of the results. Strains of the FS were found to be extremely diverse with spoligo analysis resulting in an overall diversity of 73% and 12 MIRU-VNTR analyses a diversity of 50%. Nine lineages, namely Beijing, Haarlem, LAM, S, T, X, CAS, M. bovis and U were represented by the FS isolates with the three main families (T, LAM and X) respresenting 67.6%. Spoligopattern diversity within each of these three families varied substantially from 76%, 56% and 80% for T, LAM and X respectively. The T family was the most prominent, but phylogenetic tree analysis comparing the results of different typing methods, except for one closely related T1 (SIT53) cluster, showed little relationship between them as expected from reports globally. SIT 53 strains were the most prominent family found amongst the T isolates FS stains. The LAM3/SIT33 was the largest clonal group of FS strains and s, MRC, NHLS, Faculty of Health Science, University of the Free State

Published
2009

19. Diverse Molecular Genotypes of Mycobacterium tuberculosis Complex Isolates Circulating in the Free State, South Africa.

Author

Van der Spoel van Dijk, Anneke, Makhoahle, Pakiso M., Rigouts, Leen, and Baba, Kamaldeen

Subjects
MYCOBACTERIUM tuberculosis, GENOTYPES, PUBLIC health, MULTIDRUG-resistant tuberculosis, PATHOLOGICAL physiology
Abstract

Tuberculosis is a serious public health concern especially in Africa and Asia. Studies describing strain diversity are lacking in the Free State region of South Africa. The aim of the study was to describe the diversity of Mycobacterium tuberculosis (M. tuberculosis) strain families in the Free State province of South Africa. A total of 86 M. tuberculosis isolates were genotyped using spoligotyping. A 12-locus mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTRs) typing was used to further characterize the resulting spoligotyping clusters. SITVITWEB identified 49 different patterns with allocation to six lineages including Latin-American-Mediterranean (LAM) (18 isolates), T (14 isolates), Beijing (five isolates), S (six isolates), Haarlem (one isolate), and X (five isolates), while 37 (43.0%) orphans were identified. Eight clusters included 37 isolates with identical spoligotypes (2 to 13/cluster). MIRU-VNTR typing further differentiated three spoligotyping clusters: SIT1/Beijing/MIT17, SIT33/LAM3/MIT213, and confirmed one SIT34/S/MIT311. In addition, SpolDB3/RIM assignment of the orphan strains resulted in a further 10 LAM and 13 T families. In total, LAM (28 isolates) and T (27 isolates) cause 63% of the individual cases of MTB in our study. The Free State has a highly diverse TB population with LAM being predominant. Further studies with inclusion of multidrug-resistant strains with larger sample size are warranted. [ABSTRACT FROM AUTHOR]

Published
2016
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20. Molecular epidemiology of Mycobacterium tuberculosis strains from the Free State and Northern Cape provinces, South Africa

Author

Mokhethi, Sehloho Zacharia, Van der Spoel van Dijk, Anneke, Mokhethi, Sehloho Zacharia, and Van der Spoel van Dijk, Anneke

Abstract

Background. Tuberculosis is increasing in the Free State and Northern Cape provinces of South Africa, but it is not clear how much of the disease is caused by reactivated latent infection and how much is attributed to interpersonal transmission. The discovery of the transposable DNA insertion sequence, IS6110, provided the desired polymorphism among different strains to track routes of transmission, study the degree of inter-person transmission versus reactivation, to detect laboratory contamination and disease outbreaks. Alternative methods include spoligotyping and the mycobacterial intergenic repetitive units or variable number of tandem repeats (MIRU-VNTR). Sustained studies performed on a small area in the Western Cape Province and some mines in the Gauteng Province of South Africa have found person-to-person transmission of tuberculosis to be high in these populations. In addition, resistance determinants to key antituberculosis drugs have remained unknown among tuberculosis causative organisms circulating in the Free State and Northern Cape. Thus, extensive DNA fingerprinting and gene mutation studies are needed to address these problems. Methods. An area in the Free State suitable for long-term surveillance studies was defined using available information from the governmental database, the 1996 census statistics, and tuberculosis (TB) case loads and transfer data obtained from the National Tuberculosis Database. Each clinic’s catchment information was provided by clinic managers and the population movement data from a 2002 student project. Sputum samples were collected and Mycobacterium tuberculosis isolated from tuberculosis positive patients from the defined area (Gamadi). Isoniazid resistant isolates received from a representative sample from the Free State and a few strains from the Northern Cape Province were also included in the study. IS6110-directed restriction-fragment-length polymorphism (RFLP) analysis was performed on all isolates and drug suscep

Published
2004

24. Sudden Increase in Multidrug Resistant Mycobacterium tuberculosis Strains Investigated in South-Eastern Free State, South Africa

Author

P. Makhoahle, K. le Roux, and A. Van der Spoel van Dijk

Subjects
Microbiology (medical), Free state, Tuberculosis, Incidence (epidemiology), Outbreak, General Medicine, Biology, rpoB, medicine.disease, Virology, Infectious Diseases, Genotype, medicine, Multidrug-Resistant Mycobacterium tuberculosis, South eastern
Abstract

Background: During the past decade the tuberculosis (TB) incidence escalated with new cases for the Free State reported as 793/100 000 in 2006 and approximately 60% co-infected with HIV. MDR-TB has risen to 6.9% of previously treated patients and sporadic reports of XDR-TB stress the importance of molecular surveillance and rapid testing. From October 2006 in the Mohokare district there was a sudden alarming rise to 21% of retreatment cases being MDR. The aim of the study was to investigate the possibility of a MDR-TB outbreak in the Mohokare district. Method: Specimens could be collected from 9 of 11 MDRTB patients and one contact in the Mohokare district, Free State. We used a commercially available spoligotyping kit to detect 43 known spacer sequences in the direct repeat (DR) loci of MTB to determine strain similarities and a genotype strip assay for detection of MDR and confirmed results by bidirectional cycle sequencing. Spoligotyping data was entered into an Excel spreadsheet in a binary format and compared to other strains in the world captured in the spolDB3.0 database using SPOTCLUST. Results: 5/9 of the MDR-TB cases were still positive; three of these and an additional contact’s strain was analysed. Spoligotyping suggested that all four strains belonged to different lineages namely LAM9, T1, S and T2. The LAM9 strain had the 526 (GAC3GTC/Asp3Val) rpoB and the 315 (TCG15ACC) katG mutations. The T1 and S strain had the same rpoB 531 (TCG3TTG/Ser3Leu) and 315 (TCG15ACC) katG mutation. The strain from a contact belonged to spoligotype family T2 and was susceptible. Results clearly indicate that the sudden increase in MDR cases is not due to an outbreak. Enormous problems exist in this district with non adherence to treatment, inadequate therapy and absconding of patients from Moroka MDR hospital leading to increased MDR-TB cases. Urgent attention needs to be given to solve this alarming problem.

Published
2008
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26. Anti-Inflammatory, Cytotoxic, and Anti-Tuberculosis Properties of Selected Fabaceae Medicinal Plants through in vitro Studies.

Author

Khala MM, van der Spoel van Dijk A, and Hildah Mfengwana PM

Subjects
Animals, Chlorocebus aethiops, Vero Cells, Mice, Humans, Mycobacterium tuberculosis drug effects, South Africa, Plants, Medicinal chemistry, Plant Extracts pharmacology, Anti-Inflammatory Agents pharmacology, Fabaceae chemistry, Antitubercular Agents pharmacology, Antitubercular Agents toxicity
Abstract

Background: Tuberculosis (TB) is among the top ten causes of death in South Africa and worldwide and remains a high priority of the World Health Organization. South Africa has a rich tradition for using medicinal plants to treat various diseases, including TB; however, the safety and efficacy of these plants require thorough investigation and confirmation. This study examined the anti-inflammatory and anti-TB activities of three indigenous medicinal plants against two strains of TB., Methods: Water and methanol root extracts of E. elephantina (Burch.), L. lanceolata, and T. burchellianum were tested in vitro for their activity against Latin American Mediterranean (LAM) and East African Indian (EAI) lineages. Additionally, the phytochemical screening, anti-inflammatory properties, and cytotoxicity activities of these extracts were evaluated., Results: Aqueous extracts of E. elephantina and T. burchellianum exhibited anti-inflammatory activity at a concentration of 200 μg/ml, while L. lanceolata demonstrated no activity on macrophage cells. The E. elephantina extracts showed no cytotoxicity against the Vero cells at high concentration (200 μg/ml); however, both L. lanceolata and T. burchellianum aqueous extracts were found to be cytotoxic at 200 μg/ml. Unfortunately, none of the three plant extracts showed anti-TB activity against LAM and EAI stains., Conclusion: While the tested extracts lacked direct anti-TB effects, their anti-inflammatory properties and safety profile highlight their potential for adjunctive therapy in TB management or other inflammatory conditions. Further studies are needed to explore the mechanisms and potential clinical applications of these findings.

Published
2024
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