Spread of &lt;EMPH TYPE="ITAL"&gt;Mycobacterium tuberculosis&lt;/EMPH&gt; in a Community Implementing Recommended Elements of Tuberculosis Control

Chin, Daniel P.; Crane, Charles M.; Diul, Mukadi Ya; Sun, Sumi; Agraz, Rocio; Taylor, Sirlura; Desmond, Edward; Wise, Francie

doi:10.1001/jama.283.22.2968

Cited by 71 publications

(51 citation statements)

References 22 publications

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“…A few researchers [6][7][8] have described how individual TB programs established CI processes as part of their TB control strategy in their communities. One study 9 demonstrated that many contacts were not being identified in a timely manner during the CI process. In another research effort 10 focusing on patient and staff perceptions of the CI, results confirmed the widespread existence of communication difficulties and demonstrated the need for additional staff training.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis Contact Investigation Policies, Practices, and Challenges in 11 U.S. Communities

Wilce

Shrestha-Kuwahara²,

Taylor³

et al. 2002

Journal of Public Health Management and Practice

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To describe the policies and procedures used by 11 urban tuberculosis control programs to conduct contact investigations, written policies were reviewed and semi-structured interviews were conducted with program managers and staff. Qualitative analysis showed that contact investigation policies and procedures vary widely. Most policies address risk factor assessment and contact prioritization; however, none of the policies provide comprehensive guidance for the entire process. Staffing patterns vary, but, overall, staff receive little formal training; informal monitoring practices predominate. Comprehensive guidelines and programmatic support are needed to improve the quality of contact investigation processes.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis Contact Investigation Policies, Practices, and Challenges in 11 U.S. Communities

Wilce

Shrestha-Kuwahara²,

Taylor³

et al. 2002

Journal of Public Health Management and Practice

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“…In most studies, recently transmitted TB is defined as disease occurring within 2 years of infection (1,8,9,31), although some studies have limited the latency period to 1 year (6,15,21) or extended it to 5 years after infection (36). There is a need to decide on the latency period of recent disease development so that outcomes, such as program performances, can be compared.…”

Section: Discussionmentioning

confidence: 99%

Transmission Classification Model To Determine Place and Time of Infection of Tuberculosis Cases in an Urban Area

et al. 2008

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We conducted a population-based study in the Rotterdam region of The Netherlands to determine the place and time of infection of tuberculosis (TB) cases using conventional epidemiological and genotyping information. In particular, we focused on the extent of misclassification if genotyping was not combined with epidemiological information. Cases were divided into those with a unique mycobacterial DNA fingerprint, a clustering fingerprint, and an unknown fingerprint. We developed transmission classification trees for each category to determine whether patients were infected in a foreign country or recently (<2 years) or remotely (>2 years) infected in The Netherlands. Of all TB cases during the 12-year study period, 38% were infected in a foreign country, 36% resulted from recent transmission in The Netherlands, and 18% resulted from remote infection in The Netherlands, while in the remaining cases (9%) either the time or place of infection could not be determined. The conventional epidemiological data suggested that at least 29% of clustered cases were not part of recent chains of transmission. Cases with unknown fingerprints, almost all culture negative, relatively frequently had confirmed epidemiological links with a recent pulmonary TB case in The Netherlands and were more often identified by contact tracing. Our findings highlight the idea that genotyping should be combined with conventional epidemiological investigation to establish the place and time of infection of TB cases as accurately as possible. A standardized way of classifying TB into recently, remotely, and foreign-acquired disease provides indicators for surveillance and TB control program performance that can be used to decide on interventions and allocation of resources.The steady decline of tuberculosis (TB) incidence, especially since the introduction of chemotherapy in the 1950s, was reversed in the late 1980s in many developed countries due to immigration, concurrent human immunodeficiency virus (HIV) infections, and inadequate TB control practices (16). In the last 10 years, however, the general downward trend has resumed in many of these countries, necessitating review of current TB control strategies. Several countries where the incidence of TB is low are currently developing TB elimination plans in order to reach the goal of less than 1 case per million population per year (5, 22).For TB control, it is relevant to know where and when patients were infected, because recently infected patients represent ongoing transmission, those with remotely acquired infection are a result of TB transmission in the past, and patients infected in a foreign country are an expression of the particular TB situation in that country. The absolute TB incidence and the relative contributions of recently, remotely, and foreign-acquired disease influence the choice of TB control strategies (1,14,15). The proportion of recent transmission is also an important indicator for surveillance and TB control program performance (25,27).DNA fingerprinting of Mycobacterium...

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“…In San Francisco, for example, the rates of clustered tuberculosis cases decreased significantly both overall and among persons in high-risk groups after a period during which tuberculosis control measures were intensified (66). These studies demonstrate that molecular epidemiology studies can be used as a tool to access and monitor the performance of tuberculosis control programs by targeting interventions in groups at risk that disproportionately contribute to transmission (67). However, to date there are still limits to the widespread use of genotyping to guide tuberculosis control.…”

Section: Transmission and Tuberculosis Controlmentioning

confidence: 90%

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

2004

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The resurgence of tuberculosis around the world has renewed interest in understanding the epidemiology and pathogenesis of this disease. A revolutionary advance in the field of tuberculosis research has been the development of molecular techniques that permit identification and tracking of individual strains of Mycobacterium tuberculosis. With these techniques, molecular epidemiology has been established as a new discipline that adds another dimension to the classical epidemiology of tuberculosis and has increased our understanding of the transmission dynamics of M. tuberculosis. The increased epidemiological knowledge has led to discovery of inadequacies in tuberculosis control programs; this information has helped garner resources for program improvement and has highlighted the need for the continuous surveillance of tuberculosis. Additional genetic methods are being developed based on the knowledge of the genome sequence of M. tuberculosis. These simpler and less costly genotyping techniques promise to expand the application of molecular epidemiology to developing nations (where 90% of the disease burden occurs) in support of national tuberculosis programs. Furthermore, these tools permit ever more effective probes into the dynamics of transmission, the population structure, evolution and pathogenesis of M. tuberculosis.Key words: tuberculosis, Mycobacterium tuberculosis/pathogenicity/drug effects, molecular epidemiology, genotype, DNA fingerprinting/methods, restriction fragment length polymorphins. Epidemiología molecular de la tuberculosis: métodos y aplicacionesLa reemergencia de la tuberculosis en el mundo ha despertado el interés en el entendimiento de la epidemiología y patogénesis de esta enfermedad. Un revolucionario avance en este campo de investigación ha sido el desarrollo de técnicas moleculares que permiten identificar y establecer la huella particular de cada cepa de M. tuberculosis. Con el uso de estas técnicas, y el establecimiento de la epidemilogia molecular como nueva disciplina se adicionó otra dimensión a la epidemiologia clásica de la tuberculosis y ha incrementado el conocimiento de la dinámica de la transmisión de M. tuberculosis dentro de una población. En el proceso han sido identificados problemas en los programas de control, lo cual ha ayudado a obtener recursos para su mejoramineto e implementación. Aún más, se ha resaltado la necesidad de continuar vigilando esta enfermedad. Otras metodologías genotípicas han sido desarrolladas a partir del conocimiento de la secuencia del genoma de M. tuberculosis. Estas metodologías genotípicas de fácil implementación y bajo costo se deben aplicar en países en vía de desarrollo, donde existe el 90% de la enfermedad, como apoyo a los programas de control de la tuberculosis. Estas herramientas permitirán conocer la dinámica de transmisión de la tuberculosis, la estructura de la población, la evolución y patogénesis de M. tuberculosis.Palabras clave: tuberculosis, Mycobacterium tuberculosis/patogenicidad/efecto de drogas, epidemiología molecular,...

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Spread of <EMPH TYPE="ITAL">Mycobacterium tuberculosis</EMPH> in a Community Implementing Recommended Elements of Tuberculosis Control

Abstract: Our results indicate that in a community that has implemented the essential elements of TB control, TB from ongoing transmission of M tuberculosis will continue to develop unless patients are diagnosed earlier and contacts are more completely identified. JAMA. 2000.

Cited by 71 publications

References 22 publications

Tuberculosis Contact Investigation Policies, Practices, and Challenges in 11 U.S. Communities

Tuberculosis Contact Investigation Policies, Practices, and Challenges in 11 U.S. Communities

Transmission Classification Model To Determine Place and Time of Infection of Tuberculosis Cases in an Urban Area

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

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