MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN CHIAPEAS

可以通过有针对性地采取具体措施来改善结核病控制 特定人群。化学预防是最有效的干预措施 对于疾病是由重新激活的潜伏期引起的人群 感染。而病例的发现和治疗更适合于 那些有相当大的持续传播的。目前，这些措施 是根据一个国家的发展程度来分配的。 发达国家使用化学预防和#年病例发现情况 发展中国家。 在旧金山，我们将DNA指纹技术与 常规流行病学调查以区分 重新激活并最近传播的结核病。除了……之外 以控制策略为目标，这种方法产生了有用的见解 关于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的疾病 肺结核患病率几乎是墨西哥人的三倍 全国平均水平。这种方法应该允许精确定位 这两项基本防治措施都是针对特定亚群的。此外, 对最近感染的患者进行详细调查 将确定结核病的可改变的危险因素 世界上热带和发展中地区的传播 结核病是一个主要的公共卫生问题。 此外，预计这一合作努力将在 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，墨西哥城和美国将导致 向墨西哥转让适当技术并加强结核病 控制力。

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.