Annals of Tropical Medicine and Public Health
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Year : 2012  |  Volume : 5  |  Issue : 4  |  Page : 307-312

Racial differences in susceptibility to infection by Mycobacterium tuberculosis

Department of Internal Medicine, S. Johannes Hospital, Germany

Correspondence Address:
Auda Fares
Department of Internal Medicine, S. Johannes Hospital, Wilhelm-Busch-Straße 9, 53844 Troisdorf
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.102032

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Background: The prevalence of tuberculosis among blacks is known to be higher than among whites. The basis for these differences remains unclear. The purpose of this paper is to review the literature and evaluate the data which bears on the question of racial differences in susceptibility to tuberculosis. Materials and Methods: Systematic review of peer reviewed studies identified through Medline. The search was restricted to articles published in English. The references of the identified papers for further relevant publications were also reviewed. Results: For the review, 31 papers were eligible from 417 identified in the search. The prevalence of TB among black skin people was 81.5% and 18.5% in white skin people. The black subjects demonstrated higher frequency of the Fok1 E2-C4T F allele, Bsm1 E8-G-+ 284A- B allele, APa1 e9-T-48G- a allele, and Taq1 E9-T-32C- t allele and marked differences in IL-6, IL-10, TNF-α, TGF-β, and IFN-γ than white subject. There were no significant differences in MCP-1 2518 A, G allele between black and white subjects. White subjects tended to have borderline significantly higher mean serum of vitamin D (58.4 nmol/l) than black subjects (37.7 nmol/l). The capacities of skin to synthesize vitamin D Post-UVB were significantly higher in whites than in black subjects. Conclusions: Black skin people had consistently higher susceptibility to infection by M. tuberculosis than are whites skin peoples. The mechanism of a racial difference in infectibility by M. tuberculosis is the result of a complex interaction between the environmental, immunologic, and genetic factors.

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