Genomic epidemiology of Mycobacterium tuberculosis Lineage 4 in Mato Grosso do Sul, Brazil

This study investigates the transmission dynamics of Mycobacterium tuberculosis (Mtb) in a high-burden setting. We analyzed 2,362 Mtb isolates collected in Mato Grosso do Sul, Brazil, between 2008 and 2024, including samples obtained through active case finding in prisons and routine passive surveillance. Whole-genome sequencing was performed to characterize genetic diversity, drug resistance, and transmission patterns. Phylogenetic analyses and transmission inference approaches were applied to compare symptomatic and asymptomatic cases, with a focus on understanding the role of asymptomatic tuberculosis in sustaining transmission. These data contribute to public health efforts by providing population-level insights into Mtb evolution, drug resistance, and pathways of transmission in a vulnerable population.