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      Population-Based Geospatial and Molecular Epidemiologic Study of Tuberculosis Transmission Dynamics, Botswana, 2012–2016

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          Abstract

          Tuberculosis (TB) elimination requires interrupting transmission of Mycobacterium tuberculosis. We used a multidisciplinary approach to describe TB transmission in 2 sociodemographically distinct districts in Botswana (Kopanyo Study). During August 2012–March 2016, all patients who had TB were enrolled, their sputum samples were cultured, and M. tuberculosis isolates were genotyped by using 24-locus mycobacterial interspersed repetitive units–variable number of tandem repeats. Of 5,515 TB patients, 4,331 (79%) were enrolled. Annualized TB incidence varied by geography (range 66–1,140 TB patients/100,000 persons). A total of 1,796 patient isolates had valid genotyping results and residential geocoordinates; 780 (41%) patients were involved in a localized TB transmission event. Residence in areas with a high burden of TB, age <24 years, being a current smoker, and unemployment were factors associated with localized transmission events. Patients with known HIV-positive status had lower odds of being involved in localized transmission.

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          A spatial scan statistic

          Martin Kulldorff (2007)
          Article 0 comments Cited 283 times – based on 0 reviews     Review now
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            WHO's new end TB strategy.

            Mukund Uplekar, Diana Weil, Knut Lonnroth … (2015)
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              Drivers of tuberculosis epidemics: the role of risk factors and social determinants.

              Knut Lonnroth, Ernesto Jaramillo, Brian Williams … (2009)
              The main thrust of the World Health Organization's global tuberculosis (TB) control strategy is to ensure effective and equitable delivery of quality assured diagnosis and treatment of TB. Options for including preventive efforts have not yet been fully considered. This paper presents a narrative review of the historical and recent progress in TB control and the role of TB risk factors and social determinants. The review was conducted with a view to assess the prospects of effectively controlling TB under the current strategy, and the potential to increase epidemiological impact through additional preventive interventions. The review suggests that, while the current strategy is effective in curing patients and saving lives, the epidemiological impact has so far been less than predicted. In order to reach long-term epidemiological targets for global TB control, additional interventions to reduce peoples' vulnerability for TB may therefore be required. Risk factors that seem to be of importance at the population level include poor living and working conditions associated with high risk of TB transmission, and factors that impair the host's defence against TB infection and disease, such as HIV infection, malnutrition, smoking, diabetes, alcohol abuse, and indoor air pollution. Preventive interventions may target these factors directly or via their underlying social determinants. The identification of risk groups also helps to target strategies for early detection of people in need of TB treatment. More research is needed on the suitability, feasibility and cost-effectiveness of these intervention options.
              Article 0 comments Cited 160 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): March 2021
                Volume: 27
                Issue: 3
                Pages: 835-844
                Affiliations
                [1]University of Pennsylvania Partnership, Philadelphia, Pennsylvania, USA (N.M. Zetola, C. Modongo);
                [2]Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.K. Moonan, E. Click, J.E. Oeltmann, J. Basotli, X.-J. Wen, R. Boyd, J.L. Tobias, A. Finlay)
                Author notes
                Address for correspondence: Nicola M. Zetola, University of Pennsylvania, Johnson Pavillion, Philadelphia, PA 19104-6243, USA; email: nzetola@ 123456gmail.com
                Article
                Publisher ID: 20-3840
                DOI: 10.3201/eid2703.203840
                PMC ID: 7920683
                PubMed ID: 33622470
                SO-VID: 7d05643b-4cde-42d0-a5f2-bacfa3864a9e
                History
                Categories
                Subject: Research
                Subject: Research
                Subject: Population-Based Geospatial and Molecular Epidemiologic Study of Tuberculosis Transmission Dynamics, Botswana, 2012–2016

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: tuberculosis,tb,tuberculosis and other mycobacteria,mycobacterium tuberculosis,bacteria,respiratory infections,population-based analysis,geospatial analysis,molecular epidemiology,transmission dynamics,kopanyo study,botswana
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: tuberculosis, tb, tuberculosis and other mycobacteria, mycobacterium tuberculosis, bacteria, respiratory infections, population-based analysis, geospatial analysis, molecular epidemiology, transmission dynamics, kopanyo study, botswana

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