A model of tuberculosis clustering in low incidence countries reveals more transmission in the United Kingdom than the Netherlands between 2010 and 2015.

Autor: Brooks-Pollock E; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Bristol Veterinary School, University of Bristol, Bristol, United Kingdom., Danon L; College of Engineering and Mathematical Sciences, University of Exeter, Exeter, United Kingdom.; The Alan Turing Institute, London, United Kingdom., Korthals Altes H; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Davidson JA; TB Section, Public Health England, London, United Kingdom., Pollock AMT; Department of Physics, University of Sheffield, Sheffield, United Kingdom., van Soolingen D; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.; Departments of Clinical Microbiology and Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands., Campbell C; TB Section, Public Health England, London, United Kingdom., Lalor MK; TB Section, Public Health England, London, United Kingdom.; Institute for Global Health, University College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PLoS computational biology [PLoS Comput Biol] 2020 Mar 27; Vol. 16 (3), pp. e1007687. Date of Electronic Publication: 2020 Mar 27 (Print Publication: 2020).
DOI: 10.1371/journal.pcbi.1007687
Abstrakt: Tuberculosis (TB) remains a public health threat in low TB incidence countries, through a combination of reactivated disease and onward transmission. Using surveillance data from the United Kingdom (UK) and the Netherlands (NL), we demonstrate a simple and predictable relationship between the probability of observing a cluster and its size (the number of cases with a single genotype). We demonstrate that the full range of observed cluster sizes can be described using a modified branching process model with the individual reproduction number following a Poisson lognormal distribution. We estimate that, on average, between 2010 and 2015, a TB case generated 0.41 (95% CrI 0.30,0.60) secondary cases in the UK, and 0.24 (0.14,0.48) secondary cases in the NL. A majority of cases did not generate any secondary cases. Recent transmission accounted for 39% (26%,60%) of UK cases and 23%(13%,37%) of NL cases. We predict that reducing UK transmission rates to those observed in the NL would result in 538(266,818) fewer cases annually in the UK. In conclusion, while TB in low incidence countries is strongly associated with reactivated infections, we demonstrate that recent transmission remains sufficient to warrant policies aimed at limiting local TB spread.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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