Aims Mitochondrial diseases form one of the largest groups of inborn errors of metabolism. The birth prevalence is approximately 1/5000 in well-studied populations, but little has been reported from Sub-Saharan Africa. The aim of this study was to describe the genetics underlying mitochondrial disease in South Africa.
Methods An audit was performed on all mitochondrial disease genetic testing performed in Cape Town, South Africa.
Results Of 1614 samples tested for mitochondrial DNA (mtDNA) or nuclear DNA (nDNA) variants in South Africa between 1994 and 2019, there were 155 (9.6 %) positive results. Pathogenic mtDNA variants accounted for 113 (73%)/155, from 96 families. Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes, 37 (33%)/113, Leber’s hereditary optic neuropathy, 26 (23%)/113, and single large mtDNA deletions, 22 (20%)/113, accounted for 76%. Thirty eight of 42 nDNA-positive results were homozygous for the MPV17 pathogenic variant c.106C>T (p.[Gln36Ter, Ser25Profs*49]) causing infantile neurohepatopathy, one of the largest homozygous groups reported in the literature. The other nDNA variants were in TAZ1, CPT2, BOLA3 and SERAC1. None were identified in SURF1, POLG or PDHA1.
Conclusions Finding a large group with a homozygous nuclear pathogenic variant emphasises the importance of looking for possible founder effects. The absence of other widely described pathogenic nDNA variants in this cohort may be due to reduced prevalence or insufficient testing. As advances in therapeutics develop, it is critical to develop diagnostic platforms on the African subcontinent so that population-specific genetic variations can be identified.
- medical laboratory science
- genetic diseases
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Handling editor Tahir S Pillay.
Contributors SM helped in conceptualisation, planning, conduct and reporting. EPO helped in conceptualisation and conduct. KK helped in conducting the study. GTR helped in conceptualisation, planning and reporting.
Funding This study was funded by National Health Laboratory Service.
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Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by the University of Cape Town Human Research Ethics Committee with ref: HREC/REF:024/2018.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. Our data are kept on a secure server as part of a diagnostic-linked patient database. It contains sensitive patient information only viewed by laboratory diagnostic staff under strict patient confidentiality agreements. In order to share the data used, it would first need to be deidentified and cleaned up prior to sharing. This can be done upon request, pending additional ethics clearance.
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