RT info:eu-repo/semantics/article T1 Phylogeography and transmission of Mycobacterium tuberculosis spanning prisons and surrounding communities in Paraguay A1 Estigarribia Sanabria, Gladys A1 Sequera Buzarquis, Víctor Guillermo A1 Aguirre, Sarita A1 Méndez, Julieta A1 Pereira dos Santos, Paulo César A1 Weiler Gustafson, Natalie A1 Godoy, Margarita A1 Ortíz, Analía A1 Céspedes, Cynthia A1 Martínez, Gloria A1 Alberto L., García Basteiro A1 Andrews, Jason R. A1 Croda, Julio A1 Walter, Katharine S. A2 Asociación de FuncionariosDocentes e Investigadores de la Universidad Nacional de Caaguazú AB Recent rises in incident tuberculosis (TB) cases in Paraguay and the increasing concentration of TB within prisons highlight the urgency of targeting strategies to interrupt transmission and prevent new infections. However, whether specific cities or carceral institutions play a disproportionate role in transmission remains unknown. We conducted prospective genomic surveillance, sequencing 471 Mycobacterium tuberculosis complex genomes, from inside and outside prisons in Paraguay’s two largest urban areas, Asunción and Ciudad del Este, from 2016 to 2021. We found genomic evidence of frequent recent transmission within prisons and transmission linkages spanning prisons and surrounding populations. We identified a signal of frequent M. tuberculosis spread between urban areas and marked recent population size expansion of the three largest genomic transmission clusters. Together, our findings highlight the urgency of strengthening TB control programs to reduce transmission risk within prisons in Paraguay, where incidence was 70 times that outside prisons in 2021. PB Nature Publishing Group YR 2023 FD 2023-01-19 LK http://hdl.handle.net/20.500.14066/4477 UL http://hdl.handle.net/20.500.14066/4477 LA eng NO Sanabria, G. E., Sequera, G., Aguirre, S., Méndez, J., Dos Santos, P. C. P., Gustafson, N. W., Godoy, M., Ortiz, A., Cespedes, C., Martínez, G., García Basteiro, A. L., Andrews, J. R., Croda, J., & Walter, K. S. (2023). Phylogeography and transmission of Mycobacterium tuberculosis spanning prisons and surrounding communities in Paraguay. Nature Communications, 14(1), Artículo 303. https://doi.org/10.1038/s41467-023-35813-9 NO Correspondence to Gladys Estigarribia Sanabria or Katharine S. Walter. E-mail: lalyestigarr@gmail.com; katharine.walter@hsc.utah.edu NO Consejo Nacional de Ciencia y Tecnología DS MINDS@UW RD 19-dic-2024