MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN SAN FRANCISCO

旧金山结核病的分子流行病学

• 批准号: 2069325
• 负责人: Philip C Hopewell
• 金额: $ 55.06万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-04-01 至 1996-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2069325
• 关键词: HIV infections; Mycobacterium tuberculosis; communicable disease transmission; correctional institutions; genetic strain; homeless; human genetic material tag; human migration; human subject; longitudinal human study; molecular pathology; nosocomial infections; restriction fragment length polymorphism; tuberculosis; urban area

DESCRIPTION: (Adapted from Applicant's Abstract). The hypothesis of this study is that, because of infection with the human immunodeficiency virus (HIV), homelessness and a variety of other social and medical factors, increasing proportions of cases of tuberculosis in San Francisco are the result of recent infection with Mycobacterium tuberculosis. It is postulated that these infections are acquired from identifiable sources within the community and that the sites wherein transmission of M. tuberculosis takes place can be determined. This proposal describes a community-based study in which restriction fragment length polymorphisms (RFLP) pattern analysis will be utilized in combination with intensive epidemiologic investigation to describe the distribution and dynamics of urban tuberculosis. This Study will utilize RFLP to identify clusters of cases having tuberculosis caused by the same strain, the assumption being that clustering indicates recent infection with rapid progression to disease. Thus, determining the proportion of cases in clusters would be an indicator of the number of infectious sources in the community. The questions that are sought to be answered are as follows: What is the relative proportion of the total tuberculosis cases in San Francisco who are in clusters? How do the characteristics of cases in clusters differ from noncluster cases? Can unsuspected sites and, perhaps, patterns of transmission of M. tuberculosis be identified? What are the relative contributions of health care facilities, correctional institutions, and migration to the incidence of tuberculosis in San Francisco? Can RFLP pattern analysis be useful in evaluating the adequacy of a tuberculosis control program? This study is a prospective, community-based examination with both descriptive and comparative components. The intent is to include all patients in San Francisco with newly diagnosed tuberculosis. Isolates of M. tuberculosis from all patients who have new diagnosis of tuberculosis, as well as any isolates obtained four or more months after the diagnosis, will undergo RFLP analysis. Pattern matches will be sought using an automated scanning system. After collection of the epidemiologic data is complete the RFLP data files will be linked to the epidemiologic and clinical data that will be maintained in the same computer. Analyses will be directed toward analyzing changes in cluster numbers and distribution over time, examination of clusters to track disseminators and comparisons of different variables in persons in and not in clusters, and determination of the benefits of RFLP on evaluating contact investigation procedures.

描述：（改编自申请人的摘要）。 假设 这项研究是，由于感染了人类免疫缺陷 病毒（艾滋病毒），无家可归以及其他各种社会和医学 因素，增加了SAN结核病的比例 弗朗西斯科是最近感染分枝杆菌的结果 结核。 据推测，这些感染是从中获取的 社区内的可识别来源以及 可以确定结核分枝杆菌的传播。 这 提案描述了一项基于社区的研究，其中限制片段 长度多态性（RFLP）模式分析将用于 结合密集的流行病学研究来描述 城市结核病的分布和动态。 这项研究会 利用RFLP来识别由结核病引起的病例群 相同的压力，假设聚类表明最近 随着疾病的快速发展感染。 因此，确定 集群中的案例比例将是 社区中的传染性来源。 试图的问题 回答如下： 旧金山的结核病总案例正在集群中？怎么办 集群中案例的特征与非集群案例不同？ 可以使用无引起的位点，也许是M的传播模式。 识别结核病？健康的相对贡献是什么 护理设施，惩教机构以及移民到 旧金山结核病发生率？ 可以RFLP模式分析 在评估结核病控制计划的充分性方面有用吗？ 这项研究是一项基于社区的潜在考试 描述性和比较成分。 目的是包括所有 旧金山的患者有新诊断的结核病。 分离物 所有有新诊断的患者的结核分枝杆菌 结核病以及在四个月后获得的任何分离株 诊断将进行RFLP分析。 模式匹配将是 使用自动扫描系统寻求寻求。 收集 流行病学数据完成了RFLP数据文件将链接到 将保持在同一的流行病学和临床数据 电脑。 分析将针对分析群集的变化 随着时间的推移数字和分布，检查群集以跟踪 在和比较不同变量的人中的不同变量和比较 不在集群中，也不确定RFLP对评估的好处 联系调查程序。