Who Transmits Tuberculosis to Whom: A Cross-sectional Analysis of a Cohort Study in Lima, Peru
Document Type
Article
Publication Date
2024
Keywords
Pulmonary Tuberculosis; Transmission; Whole-genome Sequencing; Interventions
Digital Object Identifier (DOI)
https://doi.org/10.1164/rccm.202307-1217OC
Abstract
Rationale: The persistent burden of tuberculosis (TB) disease emphasizes the need to identify individuals with TB for treatment and those at a high risk of incident TB for prevention. Targeting interventions toward those at high risk of developing and transmitting TB is a public health priority.
Objectives: We aimed to identify characteristics of individuals involved in TB transmission in a community setting, which may guide the prioritization of targeted interventions.
Methods: We collected clinical and sociodemographic data from a cohort of patients with TB in Lima, Peru. We used whole-genome sequencing data to assess the genetic distance between all possible pairs of patients; we considered pairs to be the result of a direct transmission event if they differed by three or fewer SNPs, and we assumed that the first diagnosed patient in a pair was the transmitter and the second was the recipient. We used logistic regression to examine the association between host factors and the likelihood of direct TB transmission.
Measurements and Main Results: Analyzing data from 2,518 index patients with TB, we identified 1,447 direct transmission pairs. Regardless of recipient attributes, individuals less than 34 years old, males, and those with a history of incarceration had a higher likelihood of being transmitters in direct transmission pairs. Direct transmission was more likely when both patients were drinkers or smokers.
Conclusions: This study identifies men, young adults, former prisoners, alcohol consumers, and smokers as priority groups for targeted interventions. Innovative strategies are needed to extend TB screening to social groups such as young adults and prisoners with limited access to routine preventive care.
Rights Information
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
American Journal of Respiratory and Critical Care Medicine, v. 210, issue 2
Scholar Commons Citation
Trevisi, Letizia; Brooks, Meredith B.; Becerra, Mercedes C.; Calderón, Roger I.; Contreras, Carmen C.; Galea, Jerome; Jimenez, Judith; Lecca, Leonid; Yataco, Rosa M.; Tovar, Ximena; Zhang, Zibiao; Murray, Megan B.; and Huang, Chuan-Chin, "Who Transmits Tuberculosis to Whom: A Cross-sectional Analysis of a Cohort Study in Lima, Peru" (2024). Social Work Faculty Publications. 287.
https://digitalcommons.usf.edu/sok_facpub/287
