BACKGROUND: The objective of this study was to identify risk factors for ongoing community transmission of tuberculosis (TB) in two densely populated urban communities with a high incidence rate of TB in Cape Town, South Africa. METHODS: Between 1993 and 1998 DNA fingerprints of mycobacterial isolates from TB patients were determined by restriction fragment length polymorphism (RFLP). Cases whose isolates shared identical fingerprint patterns were considered to belong to the same cluster and to be attributable to ongoing community transmission. RESULTS: The average annual notification rate of new smear positive TB was 238/100000. In all, 1023/1526 reported patients were culture positive, and RFLP was available for 768 (75%) of the isolates from these patients. Since some patients experienced more than one infection during the study period, 797 cases were included in the analysis. Of the cases, 575/797 (72%) were clustered. Smear-positive cases and those who were retreated after default were more likely to be clustered than smear-negative and new cases, respectively. Patients from Uitsig were more often part of large clusters than were patients from Ravensmead. Age, sex, year of diagnosis, and outcome of disease were not risk factors for clustering, nor for being the first case in a cluster, although various analytical approaches were used. CONCLUSIONS: The incidence and proportion of cases that are clustered in this area are higher than reported elsewhere. An overwhelming majority of TB cases in this area is attributed to ongoing community transmission, and only very few to reactivation. This may explain the lack of demographic risk factors for clustering.
BACKGROUND: The objective of this study was to identify risk factors for ongoing community transmission of tuberculosis (TB) in two densely populated urban communities with a high incidence rate of TB in Cape Town, South Africa. METHODS: Between 1993 and 1998 DNA fingerprints of mycobacterial isolates from TB patients were determined by restriction fragment length polymorphism (RFLP). Cases whose isolates shared identical fingerprint patterns were considered to belong to the same cluster and to be attributable to ongoing community transmission. RESULTS: The average annual notification rate of new smear positive TB was 238/100000. In all, 1023/1526 reported patients were culture positive, and RFLP was available for 768 (75%) of the isolates from these patients. Since some patients experienced more than one infection during the study period, 797 cases were included in the analysis. Of the cases, 575/797 (72%) were clustered. Smear-positive cases and those who were retreated after default were more likely to be clustered than smear-negative and new cases, respectively. Patients from Uitsig were more often part of large clusters than were patients from Ravensmead. Age, sex, year of diagnosis, and outcome of disease were not risk factors for clustering, nor for being the first case in a cluster, although various analytical approaches were used. CONCLUSIONS: The incidence and proportion of cases that are clustered in this area are higher than reported elsewhere. An overwhelming majority of TB cases in this area is attributed to ongoing community transmission, and only very few to reactivation. This may explain the lack of demographic risk factors for clustering.
Authors: Philana Ling Lin; Tara Rutledge; Angela M Green; Matthew Bigbee; Carl Fuhrman; Edwin Klein; JoAnne L Flynn Journal: AIDS Res Hum Retroviruses Date: 2012-05-04 Impact factor: 2.205
Authors: M Hanekom; G D van der Spuy; N C Gey van Pittius; C R E McEvoy; S L Ndabambi; T C Victor; E G Hoal; P D van Helden; R M Warren Journal: J Clin Microbiol Date: 2007-05-02 Impact factor: 5.948
Authors: Francesca Barletta; Larissa Otero; Bouke C de Jong; Tomotada Iwamoto; Kentaro Arikawa; Patrick Van der Stuyft; Stefan Niemann; Matthias Merker; Cécile Uwizeye; Carlos Seas; Leen Rigouts Journal: J Clin Microbiol Date: 2015-03-25 Impact factor: 5.948
Authors: S den Boon; S W P van Lill; M W Borgdorff; S Verver; E D Bateman; C J Lombard; D A Enarson; N Beyers Journal: Thorax Date: 2005-07 Impact factor: 9.139
Authors: Madalene Richardson; Gian D van der Spuy; Samantha L Sampson; Nulda Beyers; Paul D van Helden; Robin M Warren Journal: J Clin Microbiol Date: 2004-03 Impact factor: 5.948
Authors: Aurelie Cobat; Caroline J Gallant; Leah Simkin; Gillian F Black; Kim Stanley; Jane Hughes; T Mark Doherty; Willem A Hanekom; Brian Eley; Jean-Philippe Jaïs; Anne Boland-Auge; Paul van Helden; Jean-Laurent Casanova; Laurent Abel; Eileen G Hoal; Erwin Schurr; Alexandre Alcaïs Journal: J Exp Med Date: 2009-11-09 Impact factor: 14.307