Methodological problems in the molecular epidemiology of tuberculosis
Methodological problems in the molecular epidemiology of tuberculosis
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DOI：
10.1093/aje/155.6.565
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发表时间：
2002-03-15
影响因子：
5
通讯作者：
Alland, D
中科院分区：
文献类型：
--
作者：
Murray, M;Alland, D
在结核病分子流行病学的系统研究中，DNA指纹被用于估计归因于结核分枝杆菌近期传播而不是再活化疾病的事件病例的比例，并确定近期传播的风险因素。这种方法的前提是，具有相同DNA指纹的结核病病例在流行病学上是相关的，而指纹独特的病例是由于重新激活的远程感染所致。在本文中，作者回顾了结核病分子流行病学研究的目的和设计，描述了目前的分析方法，并考虑这些不同的方法对研究结果的影响。作者利用1990年至1993年在纽约纽约市结核病患者中进行的结核病流行病学调查的数据，说明了选择不同的疾病频率、比较组和抽样策略可能会影响研究结果和可解释性。他们展示了对估计结果进行敏感性分析的方法，并提出了可能提高这种方法在研究结核病方面的有用性的策略。
In systematic studies of the molecular epidemiology of tuberculosis, DNA fingerprinting is used to estimate the fraction of incident cases attributable to recent transmission of Mycobacterium tuberculosis rather than reactivation disease and to identify risk factors for recent transmission. This approach is based on the premise that tuberculosis cases that share a DNA fingerprint are epidemiologically related while cases in which fingerprints are unique are due to remote infection that has reactivated. In this paper, the authors review the objectives and design of molecular epidemiologic studies of tuberculosis, describe current analytical approaches, and consider the impact of these different approaches on study results. Using data from a previously published investigation of the epidemiology of tuberculosis conducted from 1990 to 1993 among tuberculosis patients in New York City, New York, the authors show how selecting different measures of disease frequency, comparison groups, and sampling strategies may impact the results and interpretability of the study. They demonstrate ways to conduct sensitivity analyses of estimated results and suggest strategies that may improve the usefulness of this approach to studying tuberculosis.