Molecular epidemiology of tuberculosis in the general and prison populations in the interior of São Paulo: analysis of MIRU-VNTR and RDRio sublineage

sublineage was identified in 26.8% of isolates, showing an association with alcohol use disorder (OR = 1.84; 95% CI 1.17-2.88) and illiteracy (OR = 3.40; 95% CI 1.09-10.58). Clusters with 100% similarity between GP and PDL isolates were observed, indicating intra- and extramural transmission within prison units. These findings highlight the importance of integrated surveillance and control strategies, with strengthened active case finding in both populations, in order to interrupt transmission chains and reduce the TB burden. In addition, further high-resolution genomic studies involving the PDL are recommended, focusing on complete genome sequencing integrated with epidemiological, spatial, and socio-environmental data, which will contribute to the improvement of TB surveillance and control strategies in highly vulnerable contexts.