Identifying locations of recent TB transmission in rural Uganda: a multidisciplinary approach.
Identifying locations of recent TB transmission in rural Uganda: a multidisciplinary approach.
复制标题
确定乌干达农村地区最近传播的位置：一种多学科的方法。
DOI：
10.1111/tmi.12459
复制
发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Charlebois ED
中科院分区：
文献类型：
--
作者：
Chamie G;Wandera B;Marquez C;Kato-Maeda M;Kamya MR;Havlir DV;Charlebois ED
针对结核病高传播地点可能为撒哈拉以南非洲的结核病预防提供一种新方法。我们试图描述乌干达一个乡镇的结核病传播点。我们在乌干达的托罗罗招募了一年多开始结核病治疗的成年人。54例结核病病例提供了经常接触者的姓名、居住地、卫生保健、工作和社会活动以及两份痰液样本。结核分枝杆菌（MTB）培养阳性标本进行spoligotyping，以确定具有共同基因型的菌株。我们将结核病病例的社交网络可视化，并获得、绘制和地理编码全球定位系统对病例报告的治疗前一个月经常出现的每个位置的测量。基因型聚集病例之间的空间重叠位置被认为是潜在的传播位点。确定了6个不同的基因型簇，涉及21/33（64%）的MTB培养阳性，基因分型的情况下，没有共享一个家。虽然18/54例（33%）结核病病例共享社会网络联系，但基因型聚集病例中没有一个共享社会联系。使用空间分析，我们确定了潜在的网站内集群结核病传播的六个基因型集群。除一处遗址外，所有遗址都是医疗保健和社交场所，包括饮酒、礼拜和市场。病例报告在饮酒场所花费了最大比例的治疗前人次（22.4%）。利用从诊所发现的成人结核病病例中获得的分子流行病学、地理空间和社交网络数据，我们量化了乌干达农村社区在高风险地点花费的时间，并确定了最近结核病传播最有可能的地点是医疗保健和社交场所。仅使用接触调查可能无法识别这些部位。
Targeting high TB transmission sites may offer a novel approach to TB prevention in sub-Saharan Africa. We sought to characterize TB transmission sites in a rural Ugandan township. We recruited adults starting TB treatment in Tororo, Uganda over one year. 54 TB cases provided names of frequent contacts, sites of residence, health care, work and social activities, and two sputum samples. Mycobacterium tuberculosis (MTB) culture-positive specimens underwent spoligotyping to identify strains with shared genotypes. We visualized TB case social networks, and obtained, mapped and geo-coded global positioning system measures for every location that cases reported frequenting one month before treatment. Locations of spatial overlap among genotype-clustered cases were considered potential transmission sites. Six distinct genotypic clusters were identified involving 21/33(64%) MTB culture-positive, genotyped cases; none shared a home. Although 18/54(33%) TB cases shared social network ties, none of the genotype-clustered cases shared social ties. Using spatial analysis, we identified potential sites of within-cluster TB transmission for five of six genotypic clusters. All sites but one were health care and social venues, including sites of drinking, worship and marketplaces. Cases reported spending the largest proportion of pre-treatment person-time (22.4%) at drinking venues. Using molecular epidemiology, geospatial and social network data from adult TB cases identified at clinics, we quantified person-time spent at high-risk locations across a rural Ugandan community, and determined the most likely sites of recent TB transmission to be health care and social venues. These sites may not have been identified using contact investigation alone.
登录
查看更多内容
影响因子：
5.4
作者：
Klovdahl, AS;Graviss, EA;Musser, JM
通讯作者：
Musser, JM
影响因子：
168.9
作者：
Ayles, Helen;Muyoyeta, Monde;Godfrey-Faussett, Peter
通讯作者：
Godfrey-Faussett, Peter
影响因子：
158.5
作者：
Churchyard, Gavin J.;Fielding, Katherine L.;Grant, Alison D.
通讯作者：
Grant, Alison D.
影响因子：
6.4
作者：
Cook, Victoria J.;Sun, Sumi J.;McElroy, Peter D.
通讯作者：
McElroy, Peter D.
影响因子：
168.9
作者：
Corbett, Elizabeth L.;Bandason, Tsitsi;Duong, Trinh;Dauya, Ethel;Makamure, Beauty;Churchyard, Gavin J.;Williams, Brian G.;Munyati, Shungu S.;Butterworth, Anthony E.;Mason, Peter R.;Mungofa, Stanley;Hayes, Richard J.
通讯作者：
Hayes, Richard J.