MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN CHIAPEAS

结核病控制可以通过针对以下方面的具体措施来改善： 特定人群。化学预防是最有效的干预措施 对于那些疾病是由重新激活的潜伏期 感染而病例发现和治疗更适合于 那些有相当大的持续传播。目前，这些措施 是根据一个国家的发展程度来分配的。 发达国家使用的化学预防和病例发现 发展中国家 在旧金山弗朗西斯科，我们将DNA指纹技术与 传统的流行病学调查，以区分 复发的和最近传播的结核病。除了 有针对性的控制策略，这种方法已经产生了有益的见解 结核病传播的详细流行病学。 我们现在建议使用这种分子方法来描述流行病学 在恰帕斯州传播和重新激活疾病， 结核病发病率几乎是墨西哥的三倍， 全国平均水平这一办法应能准确地瞄准 这两项基本控制措施针对特定的亚群。此外，本发明还提供了一种方法， 对最近感染的病人进行详细调查 将确定可改变的结核病风险因素 在世界热带和发展中地区传播， 结核病是一个主要的公共卫生问题。 此外，预计这一合作努力， 基础科学家、临床医生、流行病学家和公共卫生官员 来自恰帕斯州、墨西哥城和美国的移民将导致 向墨西哥转让适当的技术，加强结核病防治 控制

Tuberculosis control can be improved by targeting specific measures to specific populations. Chemoprophylaxis is the most efficient intervention for populations in which disease results from reactivated latent infection. Whereas case finding and treatment is more appropriate for those with considerable ongoing transmission. Currently, these measures are allocated based on the degree of, development of a country. Chemoprophylaxis used in developed countries and case finding in developing countries. In San Francisco we have integrated DNA fingerprinting techniques with conventional epidemiologic investigations to distinguish between reactivated and recently transmitted tuberculosis. In addition to targeting control strategies, this approach has yielded useful insights into the detailed epidemiology of tuberculosis transmission. We now propose to use this molecular approach to describe the epidemiology of transmitted and reactivated disease in the State of Chiapas, which has a tuberculosis rate that is almost three times greater than the Mexican national average. This approach should permit the precise targeting of these two basic control measures to specific subpopulations. In addition, detailed investigation of those patients who have been recently infected with tuberculosis will identify modifiable risk factors for tuberculosis transmission in tropical and developing regions of the world where tuberculosis is a major public health problem. Additionally, it is anticipated that this collaborative effort between basic scientists, clinicians, epidemiologists and public health officials from Chiapas, Mexico City, and the United States will result in the transfer of appropriate technologies to Mexico and strengthen tuberculosis control.