The Association Between Social Network Characteristics and Tuberculosis Infection Among Adults in 9 Rural Ugandan Communities.

Autor:	Marquez C; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA., Chen Y; Department of Biostatistics, University of Washington, Seattle, Washington, USA., Atukunda M; Infectious Diseases Research Collaboration, Kampala, Uganda., Chamie G; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA., Balzer LB; Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, USA., Kironde J; Infectious Diseases Research Collaboration, Kampala, Uganda., Ssemmondo E; Infectious Diseases Research Collaboration, Kampala, Uganda., Mwangwa F; Infectious Diseases Research Collaboration, Kampala, Uganda., Kabami J; Infectious Diseases Research Collaboration, Kampala, Uganda., Owaraganise A; Infectious Diseases Research Collaboration, Kampala, Uganda., Kakande E; Infectious Diseases Research Collaboration, Kampala, Uganda., Abbott R; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA., Ssekyanzi B; Infectious Diseases Research Collaboration, Kampala, Uganda., Koss C; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA., Kamya MR; Infectious Diseases Research Collaboration, Kampala, Uganda.; School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Charlebois ED; Center for AIDS Prevention Studies, School of Medicine, University of California, San Francisco, San Francisco, California, USA., Havlir DV; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA., Petersen ML; Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Feb 08; Vol. 76 (3), pp. e902-e909.
DOI:	10.1093/cid/ciac669
Abstrakt:	Background: Social network analysis can elucidate tuberculosis transmission dynamics outside the home and may inform novel network-based case-finding strategies. Methods: We assessed the association between social network characteristics and prevalent tuberculosis infection among residents (aged ≥15 years) of 9 rural communities in Eastern Uganda. Social contacts named during a census were used to create community-specific nonhousehold social networks. We evaluated whether social network structure and characteristics of first-degree contacts (sex, human immunodeficiency virus [HIV] status, tuberculosis infection) were associated with revalent tuberculosis infection (positive tuberculin skin test [TST] result) after adjusting for individual-level risk factors (age, sex, HIV status, tuberculosis contact, wealth, occupation, and Bacillus Calmette-Guérin [BCG] vaccination) with targeted maximum likelihood estimation. Results: Among 3 335 residents sampled for TST, 32% had a positive TST results and 4% reported a tuberculosis contact. The social network contained 15 328 first-degree contacts. Persons with the most network centrality (top 10%) (adjusted risk ratio, 1.3 [95% confidence interval, 1.1-1.1]) and the most (top 10%) male contacts (1.5 [1.3-1.9]) had a higher risk of prevalent tuberculosis, than those in the remaining 90%. People with ≥1 contact with HIV (adjusted risk ratio, 1.3 [95% confidence interval, 1.1-1.6]) and ≥2 contacts with tuberculosis infection were more likely to have tuberculosis themselves (2.6 [ 95% confidence interval: 2.2-2.9]). Conclusions: Social networks with higher centrality, more men, contacts with HIV, and tuberculosis infection were positively associated with tuberculosis infection. Tuberculosis transmission within measurable social networks may explain prevalent tuberculosis not associated with a household contact. Further study on network-informed tuberculosis case finding interventions is warranted. Competing Interests: Potential conflicts of interest. G. C. reports participation on a data safety monitoring board or advisory board as a member of a data monitoring committee for an National Institutes of Health (NIH)–funded clinical trial (TB Screening Improves Preventive Therapy Uptake [TB SCRIPT] trial). E. D. C. reports support from the NIH (grant 1R01AI151209-01 [paid to institution]) and consulting fees from the Infectious Diseases Research Collaboration, Kampala, Uganda (paid to the author for Integrated HIV & Hypertension Study consulting). D. V. H. reports nonfinancial support from Gilead (drug donation for an NIH study) and Abbott (diagnostic test donation). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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