RESEARCH ARTICLE High Rates of Non-Tuberculous Mycobacteria Isolation in Mozambican Children with Presumptive Tuberculosis Elisa Lo ´ pez-Varela 1,2 *, Alberto L. Garcı ´a-Basteiro 1,2,3 , Orvalho J. Augusto 1 , Oscar Fraile 1,2 , Helder Bulo 1 , Tasmiya Ira 1 , Kizito Gondo 1 , Jakko van Ingen 4 , Denise Naniche 2 *, Jahit Sacarlal 1,5 , Pedro L. Alonso 1,2 1 Centro de Investigac ¸ ão em Saude de Manhic ¸a (CISM), Maputo, Mozambique, 2 ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clı ´nic de Barcelona, Universitat de Barcelona, Barcelona, Spain, 3 Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands, 4 Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands, 5 Departamento de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique * Elisa.lopez@isglobal.org (ELV); denise.naniche@isglobal.org (DN) Abstract Introduction Non-tuberculous mycobacteria (NTM) can cause disease which can be clinically and radio- logically undistinguishable from tuberculosis (TB), posing a diagnostic and therapeutic chal- lenge in high TB settings. We aim to describe the prevalence of NTM isolation and its clinical characteristics in children from rural Mozambique. Methods This study was part of a community TB incidence study in children <3 years of age. Gas- tric aspirate and induced sputum sampling were performed in all presumptive TB cases and processed for smear testing using fluorochrome staining and LED Microscopy, liquid and solid culture, and molecular identification by GenoType ® Mycobacterium CM/AS assays. Results NTM were isolated in 26.3% (204/775) of children. The most prevalent NTM species was M. intracellulare (N = 128), followed by M. scrofulaceum (N = 35) and M. fortuitum (N = 9). Chil- dren with NTM were significantly less symptomatic and less likely to present with an abnor- mal chest radiograph than those with M. tuberculosis. NTM were present in 21.6% of follow- up samples and 25 children had the same species isolated from 2 separate samples. All were considered clinically insignificant and none received specific treatment. Children with NTM isolates had equal all cause mortality and likelihood of TB treatment as those with neg- ative culture although they were less likely to have TB ruled out. PLOS ONE | DOI:10.1371/journal.pone.0169757 January 17, 2017 1 / 12 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Lo ´pez-Varela E, L. Garcı ´a-Basteiro A, Augusto OJ, Fraile O, Bulo H, Ira T, et al. (2017) High Rates of Non-Tuberculous Mycobacteria Isolation in Mozambican Children with Presumptive Tuberculosis. PLoS ONE 12(1): e0169757. doi:10.1371/journal.pone.0169757 Editor: Jean Louis Herrmann, Hopital Raymond Poincare - Universite Versailles St. Quentin, FRANCE Received: July 24, 2016 Accepted: December 21, 2016 Published: January 17, 2017 Copyright: © 2017 Lo ´pez-Varela et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: This work was supported by the European & Developing Countries Clinical Trials Partnership [IP_07_32080_003]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.