Giving TB wheels: Public transportation as a risk factor for tuberculosis transmission
Autor: | James M. Musser, Marsha L. Feske, Edward A. Graviss, Larry D. Teeter |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male Microbiology (medical) Tuberculosis Adolescent Genotype Immunology Poison control Microbiology law.invention Young Adult Risk Factors law medicine Cluster Analysis Humans Risk factor Child business.industry Incidence (epidemiology) technology industry and agriculture Mycobacterium tuberculosis Middle Aged medicine.disease Texas Metropolitan area Health equity Motor Vehicles Infectious Diseases Geography Transmission (mechanics) Public transport Geographic Information Systems Female business human activities Demography |
Zdroj: | Tuberculosis. 91:S16-S23 |
ISSN: | 1472-9792 |
DOI: | 10.1016/j.tube.2011.10.005 |
Popis: | Previous geospatial analysis of the well-defined Houston Tuberculosis Initiative (HTI) database identified an association between the use of city-bus transportation (inclusive of time onboard) and Tuberculosis (TB) incidence in Houston/Harris County census tracts (paper submitted). This paper is an extension of those findings. Contact investigations on school buses have reported a high rate of positive tuberculin skin tests in the persons traveling with the index case and have shown an association with bus ride duration. In Houston, city bus routes are veins connecting even the most diverse of populations within the metropolitan area. Among HTI participants, TB patients who reported weekly bus use were more likely to have demographic and social risk factors associated with poverty, immune suppression and health disparities. An equal proportion of bus riders and non-bus riders were cultured for Mycobacterium tuberculosis (MTB), yet 75% of bus riders were clustered with a mean cluster size of 50.14, indicating recent transmission, compared to 56% of non-bus riders (OR = 2.4, p < 0.001) with a mean cluster size of 28.9 (p < 0.01). Individual bus routes, including one route servicing the local hospitals, were found to be risk factors for endemic MTB clustered strains and the routes themselves geographically connect the census tracts previously identified as having endemic TB. |
Databáze: | OpenAIRE |
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