Genomic Evolution and Dynamics of Drug Resistance in Mycobacterium Tuberculosis across West Africa- A Review

Background: The continuous evolution of drug-resistant Tuberculosis strains around the globe, particularly in West Africa, continues to be a major public health problem and poses serious threats to the actualization of the ”End Tuberculosis Strategy” projected by 2030. Hence, a comprehensive knowledge on genetic variations, lineage distributions and evolutionary adaptations implicated in M. tuberculosis drug-resistance could strengthen research efforts in TB control. Objectives: This review summarizes the genetic mechanisms of drug resistance in Mycobacterium tuberculosis and the extent to which they pose threats to public health. It also gives recommendations on managing drug resistant TB in West Africa. Literature Search: This review assesses available literature relating to the genomic evolution and dynamics of drug resistance in Mycobacterium tuberculosis across west Africa. Search for relevant articles in databases such as Google Scholar, PubMed, Scopus and Web of Science was conducted using keywords such as “Genomics”, “Evolution”, “Drug Resistance”, “Mycobacterium tuberculosis” and “West Africa “. Sixty articles were found in this search and forty-six articles were selected and reviewed. Results: Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB), which are common in West Africa, have been linked to the MTBC Lineages 5 and 6 also known as M. africanum. The devastating challenges these resistant strains exert on public health justified the urgency for exploring novel therapeutic avenues, improved diagnostic protocol, and robust healthcare systems to curb the disease. Conclusion: This review maintained a strong advocacy for proper public health education, installation of adequate surveillance systems, and the adoption of alternative therapeutic modalities to tackle drug-resistant M. tuberculosis, effectively in West Africa and mitigate the public health burden it poses globally.