An explanation for the low proportion of tuberculosis that results from transmission between household and known social contacts.
An explanation for the low proportion of tuberculosis that results from transmission between household and known social contacts.
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DOI：
10.1038/s41598-018-23797-2
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发表时间：
2018-03-29
影响因子：
4.6
通讯作者：
White RG
中科院分区：
文献类型：
--
作者：
McCreesh N;White RG
我们目前几乎不知道结核分枝杆菌(Mtb)在高发环境中在哪里传播。分子研究表明，只有大约8%-19%的成人传播发生在家庭内或已知的社交接触之间。这与社交接触研究的结果形成了鲜明对比，后者显示，大部分接触时间发生在家庭、工作场所和学校。建立了社会接触行为和结核分枝杆菌传播的数学模型，纳入了易感性和传染性的变化。模拟了三种接触类型：家庭接触、重复接触(家庭外个体重复接触，每日-每月频率)和非重复接触。该模型使用南非开普敦的数据，按接触类型对接触人数和接触持续时间的平均值和方差进行了参数化，并与开普敦继发病例数量的过度分散(“超级传播”)的估计值相吻合。家庭接触、重复接触和不重复接触分别占接触时间的36%、13%和51%，占疾病的13%、8%和79%。结果表明，接触饱和，由于疾病持续时间长和过度传播而加剧，导致在非重复接触之间传播的比例很高。因此，家庭和社会接触者追踪不太可能触及大多数结核病病例。迫切需要更好地了解传播地点和确定超级传播者的方法，以改进结核病预防战略。
We currently have little idea where Mycobacterium tuberculosis (Mtb) transmission occurs in high incidence settings. Molecular studies suggest that only around 8–19% of transmission to adults occurs within-household, or between known social-contacts. This contrasts with findings from social-contact studies, which show that substantial proportions of contact time occur in households, workplaces and schools. A mathematical model of social-contact behaviour and Mtb transmission was developed, incorporating variation in susceptibility and infectiousness. Three types of contact were simulated: household, repeated (individuals outside household contacted repeatedly with daily-monthly frequency) and non-repeated. The model was parameterised using data from Cape Town, South Africa, on mean and variance in contact numbers and contact durations, by contact type, and fitted to an estimate of overdispersion in numbers of secondary cases (‘superspreading’) in Cape Town. Household, repeated, and non-repeated contacts contributed 36%, 13%, and 51% of contact time, and 13%, 8%, and 79% of disease, respectively. Results suggest contact saturation, exacerbated by long disease durations and superspreading, cause the high proportion of transmission between non-repeated contacts. Household and social-contact tracing is therefore unlikely to reach most tuberculosis cases. A better understanding of transmission locations, and methods to identify superspreaders, are urgently required to improve tuberculosis prevention strategies.
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影响因子：
3.7
作者：
Glynn, Judith R.;Guerra-Assuncao, Jose Afonso;Clark, Taane G.
通讯作者：
Clark, Taane G.
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DOI：
10.1111/tmi.12459
发表时间：
2015-04
期刊：
Tropical medicine & international health : TM & IH
影响因子：
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作者：
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DOI：
10.1098/rspb.1997.0131
发表时间：
1997-07-22
影响因子：
4.7
作者：
Edmunds, WJ;OCallaghan, CJ;Nokes, DJ
通讯作者：
Nokes, DJ
影响因子：
1.4
作者：
Eames, K. T. D.
通讯作者：
Eames, K. T. D.
影响因子：
168.9
作者：
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通讯作者：
van Helden, PD