Social Mixing and Clinical Features Linked With Transmission in a Network of Extensively Drug-resistant Tuberculosis Cases in KwaZulu-Natal, South Africa
| Autor: | Sara C. Auld, Kristin N. Nelson, Koleka Mlisana, Samuel M. Jenness, Pravi Moodley, Salim Allana, Benjamin A. Lopman, Barun Mathema, Shaheed V. Omar, N. Sarita Shah, James C.M. Brust, Nazir Ahmed Ismail, Tyler S. Brown, Angie Campbell, Neel R. Gandhi |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Tuberculosis Extensively Drug-Resistant Tuberculosis Antitubercular Agents Psychological intervention Disease law.invention Mycobacterium tuberculosis 03 medical and health sciences South Africa 0302 clinical medicine law Environmental health Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine Articles and Commentaries Cause of death biology business.industry Extensively drug-resistant tuberculosis biology.organism_classification medicine.disease 030104 developmental biology Infectious Diseases Transmission (mechanics) Sputum medicine.symptom business |
| Zdroj: | Clin Infect Dis |
| Popis: | Background Tuberculosis (TB) is the leading infectious cause of death globally, and drug-resistant TB strains pose a serious threat to controlling the global TB epidemic. The clinical features, locations, and social factors driving transmission in settings with high incidences of drug-resistant TB are poorly understood. Methods We measured a network of genomic links using Mycobacterium tuberculosis whole-genome sequences. Results Patients with 2–3 months of cough or who spent time in urban locations were more likely to be linked in the network, while patients with sputum smear–positive disease were less likely to be linked than those with smear-negative disease. Associations persisted using different thresholds to define genomic links and irrespective of assumptions about the direction of transmission. Conclusions Identifying factors that lead to many transmissions, including contact with urban areas, can suggest settings instrumental in transmission and indicate optimal locations and groups to target with interventions. |
| Databáze: | OpenAIRE |
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