Individual- and neighborhood-level contextual factors are associated with Mycobacterium tuberculosis transmission: genotypic clustering of cases in Michigan, 2004-2012.
Individual- and neighborhood-level contextual factors are associated with Mycobacterium tuberculosis transmission: genotypic clustering of cases in Michigan, 2004-2012.
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DOI：
10.1016/j.annepidem.2017.05.009
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发表时间：
2017-06
影响因子：
5.6
通讯作者：
Wilson ML
中科院分区：
文献类型：
--
作者：
Noppert GA;Yang Z;Clarke P;Ye W;Davidson P;Wilson ML
利用结核病监测项目报告的新病例中结核分枝杆菌分离株的基因分型数据，我们评估了美国结核病监测项目中最近结核病传播的个人和社区水平的风险因素。出生和外国出生的人口。使用多变量泊松回归模型分析了2004-2012年期间密歇根州报告的结核病例（N= 1，236），以检查美国最近横断面传播的风险因素。出生和外国出生的人口分别。最近的传播是根据间隔寡核苷酸型和12个位点MIRU-VNTR匹配的细菌从病例中被诊断出一年内彼此定义。研究了四类预测变量：人口统计学因素、已知的结核病危险因素、临床特征和社区水平因素。总体而言，22%的外国出生病例是最近传播的。在外国出生的人中，种族和接触传染性结核病病例是最近传播的重要预测因素。超过一半（52%）的美国-出生病例是由最近的传播引起的。在美国-出生后，最近的传播可以通过个人和社区层面的社会人口特征来预测。旨在降低外国出生者结核病发病率的干预措施应侧重于减少潜伏感染的重新激活。然而，降低美国结核病发病率-出生的艾滋病毒需要在个人和社区一级减少社会弱势群体之间的传播。本报告填补了美国结核病当代社会背景方面的一个重要知识空白，从而为今后的公共卫生政策研究奠定基础，从而制定更有针对性的有效结核病控制措施。
Using genotyping data of Mycobacterium tuberculosis isolates from new cases reported to the TB surveillance program, we evaluated risk factors for recent TB transmission at both the individual- and neighborhood-levels among U.S.-born and foreign-born populations. TB cases (N=1,236) reported in Michigan during 2004–2012 were analyzed using multivariable Poisson regression models to examine risk factors for recent transmission cross-sectionally for U.S.-born and foreign-born populations separately. Recent transmission was defined based on spoligotype and 12-locus-MIRU-VNTR matches of bacteria from cases that were diagnosed within one year of each other. Four classes of predictor variables were examined: demographic factors, known TB risk factors, clinical characteristics, and neighborhood-level factors. Overall, 22% of the foreign-born cases resulted from recent transmission. Among the foreign-born, race and being a contact of an infectious TB case were significant predictors of recent transmission. More than half (52%) of U.S.-born cases resulted from recent transmission. Among the U.S.-born, recent transmission was predicted by both individual- and neighborhood-level socio-demographic characteristics. Interventions aimed at reducing TB incidence among foreign-born should focus on reducing reactivation of latent infection. However, reducing TB incidence among the U.S.-born will require decreasing transmission among socially disadvantaged groups at the individual- and neighborhood-level. This report fills an important knowledge gap regarding the contemporary social context of TB in the U.S., thereby providing a foundation for future studies of public health policies that can lead to the development of more targeted effective TB control.
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影响因子：
5.5
作者：
Kramer MR;Hogue CR
通讯作者：
Hogue CR
影响因子：
5
作者：
Geronimus AT;Pearson JA;Linnenbringer E;Schulz AJ;Reyes AG;Epel ES;Lin J;Blackburn EH
通讯作者：
Blackburn EH
使用基因分型和地理空间扫描来估计美国最近的结核分枝杆菌传播。
影响因子：
11.8
作者：
Moonan PK;Ghosh S;Oeltmann JE;Kammerer JS;Cowan LS;Navin TR
通讯作者：
Navin TR
影响因子：
12.7
作者：
Acevedo-Garcia, D
通讯作者：
Acevedo-Garcia, D
影响因子：
4.5
作者：
Noppert, Grace A.;Wilson, Mark L.;Yang, Zhenhua
通讯作者：
Yang, Zhenhua