Characterizing tuberculosis transmission dynamics in high-burden urban and rural settings.

Autor: Smith JP; Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA. jonathan.p.smith@yale.edu.; Peraton, 2800 Century Pkwy NE, Atlanta, GA, USA. jonathan.p.smith@yale.edu., Oeltmann JE; Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, GA, USA., Hill AN; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA., Tobias JL; Peraton, 2800 Century Pkwy NE, Atlanta, GA, USA., Boyd R; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA., Click ES; Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, GA, USA., Finlay A; Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, GA, USA., Mondongo C; Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia, USA., Zetola NM; Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia, USA., Moonan PK; Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2022 Apr 26; Vol. 12 (1), pp. 6780. Date of Electronic Publication: 2022 Apr 26.
DOI: 10.1038/s41598-022-10488-2
Abstrakt: Mycobacterium tuberculosis transmission dynamics in high-burden settings are poorly understood. Growing evidence suggests transmission may be characterized by extensive individual heterogeneity in secondary cases (i.e., superspreading), yet the degree and influence of such heterogeneity is largely unknown and unmeasured in high burden-settings. We conducted a prospective, population-based molecular epidemiology study of TB transmission in both an urban and rural setting of Botswana, one of the highest TB burden countries in the world. We used these empirical data to fit two mathematical models (urban and rural) that jointly quantified both the effective reproductive number, [Formula: see text], and the propensity for superspreading in each population. We found both urban and rural populations were characterized by a high degree of individual heterogeneity, however such heterogeneity disproportionately impacted the rural population: 99% of secondary transmission was attributed to only 19% of infectious cases in the rural population compared to 60% in the urban population and the median number of incident cases until the first outbreak of 30 cases was only 32 for the rural model compared to 791 in the urban model. These findings suggest individual heterogeneity plays a critical role shaping local TB epidemiology within subpopulations.
(© 2022. The Author(s).)
Databáze: MEDLINE
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