Age- and Sex-Specific Social Contact Patterns and Incidence of Mycobacterium tuberculosis Infection.
Age- and Sex-Specific Social Contact Patterns and Incidence of Mycobacterium tuberculosis Infection.
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DOI：
10.1093/aje/kwv160
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发表时间：
2016-01-15
影响因子：
5
通讯作者：
White RG
中科院分区：
文献类型：
--
作者：
Dodd PJ;Looker C;Plumb ID;Bond V;Schaap A;Shanaube K;Muyoyeta M;Vynnycky E;Godfrey-Faussett P;Corbett EL;Beyers N;Ayles H;White RG
我们的目的是利用儿童感染发生率、成人疾病流行率和社会接触模式的数据来模拟成人结核分枝杆菌感染的发生率。 2011年，我们对成年人进行了一项横断面面对面调查，列举了16个赞比亚社区和8个南非社区的“亲密”（共同交谈）和“休闲”（共享室内空间）社交接触。我们使用这些接触模式，以及观察到的儿童结核分枝杆菌感染发病率和成人结核病患病率，对所有年龄段的结核分枝杆菌感染发病率进行了建模。共有 3,528 名成年人参与了这项研究。报告的密切和偶然接触率分别为每名成人每天 4.9 次（95% 置信区间：4.6、5.2）和每名成人每天 10.4 次（95% 置信区间：9.3、11.6）。大家庭和农村地区成年人的密切接触率较高。年龄组和性别内的密切接触者优先混合。成人结核分枝杆菌感染的估计发病率比儿童高 1.5-6 倍（每年 2.5%-10%）。据估计，超过 50% 的男性、女性和儿童感染是由于与成年男性接触造成的。我们的结论是，基于儿童调查的感染发生率估计可能会低估成人的感染发生率。大多数感染可能是由于与成年男性接触所致。男性结核病的治疗和控制对于保护男性、女性和儿童免受结核病至关重要。
We aimed to model the incidence of infection with Mycobacterium tuberculosis among adults using data on infection incidence in children, disease prevalence in adults, and social contact patterns. We conducted a cross-sectional face-to-face survey of adults in 2011, enumerating “close” (shared conversation) and “casual” (shared indoor space) social contacts in 16 Zambian communities and 8 South African communities. We modeled the incidence of M. tuberculosis infection in all age groups using these contact patterns, as well as the observed incidence of M. tuberculosis infection in children and the prevalence of tuberculosis disease in adults. A total of 3,528 adults participated in the study. The reported rates of close and casual contact were 4.9 per adult per day (95% confidence interval: 4.6, 5.2) and 10.4 per adult per day (95% confidence interval: 9.3, 11.6), respectively. Rates of close contact were higher for adults in larger households and rural areas. There was preferential mixing of close contacts within age groups and within sexes. The estimated incidence of M. tuberculosis infection in adults was 1.5–6 times higher (2.5%–10% per year) than that in children. More than 50% of infections in men, women, and children were estimated to be due to contact with adult men. We conclude that estimates of infection incidence based on surveys in children might underestimate incidence in adults. Most infections may be due to contact with adult men. Treatment and control of tuberculosis in men is critical to protecting men, women, and children from tuberculosis.