The Association Between Social Network Characteristics and Tuberculosis Infection Among Adults in 9 Rural Ugandan Communities.
The Association Between Social Network Characteristics and Tuberculosis Infection Among Adults in 9 Rural Ugandan Communities.
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乌干达 9 个农村社区成年人的社交网络特征与结核病感染之间的关联。
DOI：
10.1093/cid/ciac669
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kamya,Moses
中科院分区：
文献类型：
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作者：
Marquez,Carina;Chen,Yiqun;Atukunda,Mucunguzi;Chamie,Gabriel;Balzer,LauraB;Kironde,Joel;Ssemmondo,Emmanuel;Mwangwa,Florence;Kabami,Jane;Owaraganise,Asiphas;Kakande,Elijah;Abbott,Rachel;Ssekyanzi,Bob;Koss,Catherine;Kamya,Moses
BackgroundSocial Network analysis可以阐明结核病在家外的传播动态，并可能告知新的基于网络的病例发现strategies.MethodsWe评估了乌干达东部9个农村社区的居民（年龄≥15岁）之间的社会网络特征和结核病流行感染之间的关联。在人口普查中命名的社会联系人被用来创建社区特定的非家庭社交网络。我们评估了一级接触者的社会网络结构和特征是否（性别、人类免疫缺陷病毒[HIV]感染、结核病感染）与结核病复发有关（结核菌素皮肤试验[TST]阳性结果）调整个体水平风险因素后（年龄、性别、艾滋病毒感染状况、结核病接触情况、财富、职业、结果在3 335名TST抽样的居民中，32%的TST结果阳性，4%的人报告有结核病接触者。该社交网络包含15328个一级联系人。与其余90%的人群相比，网络中心性最强（前10%）（调整后风险比，1.3 [95%置信区间，1.1-1.1]）和男性接触最多（前10%）（1.5 [1.3-1.9]）的人群患结核病的风险更高。与艾滋病毒有≥1次接触的人（调整后的危险比，1.3 [95%可信区间，1.1-1.6]）和≥2次接触结核感染者本身更可能患有结核病（2.6 [ 95%置信区间：2.2-2.9]）。结论社会网络具有较高的中心性，更多的男性，接触艾滋病毒，结核感染与肺结核感染呈正相关。结核病在可测量的社交网络内传播可以解释与家庭接触无关的结核病流行。网络信息结核病发现干预措施有待进一步研究。
BackgroundSocial network analysis can elucidate tuberculosis transmission dynamics outside the home and may inform novel network-based case-finding strategies.MethodsWe assessed the association between social network characteristics and prevalent tuberculosis infection among residents (aged ≥15 years) of 9 rural communities in Eastern Uganda. Social contacts named during a census were used to create community-specific nonhousehold social networks. We evaluated whether social network structure and characteristics of first-degree contacts (sex, human immunodeficiency virus [HIV] status, tuberculosis infection) were associated with revalent tuberculosis infection (positive tuberculin skin test [TST] result) after adjusting for individual-level risk factors (age, sex, HIV status, tuberculosis contact, wealth, occupation, and Bacillus Calmette–Guérin [BCG] vaccination) with targeted maximum likelihood estimation.ResultsAmong 3 335 residents sampled for TST, 32% had a positive TST results and 4% reported a tuberculosis contact. The social network contained 15 328 first-degree contacts. Persons with the most network centrality (top 10%) (adjusted risk ratio, 1.3 [95% confidence interval, 1.1–1.1]) and the most (top 10%) male contacts (1.5 [1.3–1.9]) had a higher risk of prevalent tuberculosis, than those in the remaining 90%. People with ≥1 contact with HIV (adjusted risk ratio, 1.3 [95% confidence interval, 1.1–1.6]) and ≥2 contacts with tuberculosis infection were more likely to have tuberculosis themselves (2.6 [ 95% confidence interval: 2.2–2.9]).ConclusionsSocial networks with higher centrality, more men, contacts with HIV, and tuberculosis infection were positively associated with tuberculosis infection. Tuberculosis transmission within measurable social networks may explain prevalent tuberculosis not associated with a household contact. Further study on network-informed tuberculosis case finding interventions is warranted.