Kristin N Nelson1, Samuel M Jenness1, Barun Mathema2, Benjamin A Lopman1, Sara C Auld1,3, N Sarita Shah4, James C M Brust5, Nazir Ismail6,7, Shaheed Vally Omar6, Tyler S Brown8, Salim Allana1, Angie Campbell1, Pravi Moodley9,10, Koleka Mlisana9,10, Neel R Gandhi1,3. 1. Rollins School of Public Health, Emory University, Atlanta, Georgia. 2. Mailman School of Public Health, Columbia University, New York, New York. 3. Emory University School of Medicine, Atlanta, Georgia. 4. US Centers for Disease Control and Prevention, Atlanta, Georgia. 5. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York. 6. National Institute for Communicable Diseases, Johannesburg, South Africa. 7. University of Pretoria, South Africa. 8. Massachusetts General Hospital, Infectious Diseases Division, Boston. 9. National Health Laboratory Service, Durban, South Africa. 10. School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.
Abstract
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.
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.
Authors: Kristin N Nelson; N Sarita Shah; Barun Mathema; Nazir Ismail; James C M Brust; Tyler S Brown; Sara C Auld; Shaheed Vally Omar; Natashia Morris; Angie Campbell; Salim Allana; Pravi Moodley; Koleka Mlisana; Neel R Gandhi Journal: J Infect Dis Date: 2018-11-05 Impact factor: 5.226
Authors: N Sarita Shah; Sara C Auld; James C M Brust; Barun Mathema; Nazir Ismail; Pravi Moodley; Koleka Mlisana; Salim Allana; Angela Campbell; Thuli Mthiyane; Natashia Morris; Primrose Mpangase; Hermina van der Meulen; Shaheed V Omar; Tyler S Brown; Apurva Narechania; Elena Shaskina; Thandi Kapwata; Barry Kreiswirth; Neel R Gandhi Journal: N Engl J Med Date: 2017-01-19 Impact factor: 91.245
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