Sociological variety and the transmission efficiency of Mycobacterium tuberculosis: a secondary analysis of qualitative and quantitative data from 15 communities in Zambia.
Sociological variety and the transmission efficiency of Mycobacterium tuberculosis: a secondary analysis of qualitative and quantitative data from 15 communities in Zambia.
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DOI：
10.1136/bmjopen-2020-047136
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发表时间：
2021-12-14
期刊：
影响因子：
2.9
通讯作者：
Bond V
中科院分区：
文献类型：
--
作者：
Murray EJ;Dodd PJ;Marais B;Ayles H;Shanaube K;Schaap A;White RG;Bond V
选定的赞比亚社区组成了一个集群随机试验的一部分：赞比亚和南非结核病和艾滋病减少研究（ZAMSTAR）。在这些社区中，结核分枝杆菌感染和结核病的患病率存在很大差异。我们试图澄清特定的社区是否更容易/更不容易受到M。结核病的传播是与传播效率相关的社会学多样性的结果。我们使用现有数据集进行了混合方法二次分析。首先，我们分析了定性数据，以分类和合成跨社区的社会空间参与模式。其次，我们比较了突发社会学变量与传播效率的衡量标准：年度感染风险与结核病患病率的比率。赞比亚城市和城郊的ZAMSTAR社区，跨越五个省。15个社区，每个社区都有一个卫生设施，为至少25 000人提供结核病治疗。结核病报告率每年至少为每10万人400例，艾滋病毒血清阳性率估计很高。不同社区的人群拥挤、流动、生计和参与娱乐活动的情况各不相同。基于12个社会空间指标，社区被定性为空间拥挤程度或高或低，以及与他人接触的社会开放程度或高或低，这对M的推定风险有影响。结核病传播。例如，在通风不良的建筑物中观看视频节目在社会开放的社区构成推定风险，而户外耕作和/或捕鱼在传播措施较低的社区特别普遍。“社会渗透性”和拥挤的双重动力似乎与M。结核病传播效率为了减少传播，可以调整某些社会空间方面（例如，增加交通工具的通风），而更多的结构方面则不那么具有可塑性（例如，依赖公共交通）。我们建议将社区水平的类型学与基因组测序技术相结合，以进一步探索“社会渗透性”的意义。ISRCTN36729271。
Selected Zambian communities formed part of a cluster randomised trial: the Zambia and South Africa TB and AIDS Reduction study (ZAMSTAR). There was wide variability in the prevalence of Mycobacterium tuberculosis infection and tuberculosis (TB) disease across these communities. We sought to clarify whether specific communities could have been more/less vulnerable to M. tuberculosis transmission as a result of sociological variety relevant to transmission efficiency. We conducted a mixed methods secondary analysis using existing data sets. First, we analysed qualitative data to categorise and synthesise patterns of socio-spatial engagement across communities. Second, we compared emergent sociological variables with a measure of transmission efficiency: the ratio of the annual risk of infection to TB prevalence. ZAMSTAR communities in urban and peri-urban Zambia, spanning five provinces. Fifteen communities, each served by a health facility offering TB treatment to a population of at least 25 000. TB notification rates were at least 400 per 100 000 per annum and HIV seroprevalence was estimated to be high. Crowding, movement, livelihoods and participation in recreational activity differed across communities. Based on 12 socio-spatial indicators, communities were qualitatively classified as more/less spatially crowded and as more/less socially ‘open’ to contact with others, with implications for the presumptive risk of M. tuberculosis transmission. For example, watching video shows in poorly ventilated structures posed a presumptive risk in more socially open communities, while outdoor farming and/or fishing were particularly widespread in communities with lower transmission measures. A dual dynamic of ‘social permeability’ and crowding appeared relevant to disparities in M. tuberculosis transmission efficiency. To reduce transmission, certain socio-spatial aspects could be adjusted (eg, increasing ventilation on transport), while more structural aspects are less malleable (eg, reliance on public transport). We recommend integrating community level typologies with genome sequencing techniques to further explore the significance of ‘social permeability’. ISRCTN36729271.
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发表时间：
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期刊：
The Journal of infectious diseases
影响因子：
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发表时间：
2017-11-03
期刊：
The Journal of infectious diseases
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