Evidence map›Paper›PMID 25189547›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2014

Rapid impact of effective treatment on transmission of multidrug-resistant tuberculosis.

A S Dharmadhikari, M Mphahlele, K Venter, A Stoltz, R Mathebula, T Masotla, M van der Walt, M Pagano, P Jensen, E Nardell

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02355223 (Finding and Treating Unsuspected and Resistant TB to Reduce Hospital Transmission), which is not on this map. Cited by 84 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 7 pooled it
8.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02355223 naunknown statusnot on this mapstarted 2016, after this paper: background citation

Finding and Treating Unsuspected and Resistant TB to Reduce Hospital Transmission

TypeinterventionalSponsorBrigham and Women's HospitalRan2016 to 2020Enrolled11,060ConditionsTuberculosisArmsFAST
3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 7 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Effects of Respiratory Isolation for Tuberculosis to Reduce Community-based Transmission: A Systematic Review.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019
    Guideline
  6. Preventing the spread of multidrug-resistant tuberculosis and protecting contacts of infectious cases.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2017
    Pooled it
  7. Guideline
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Community-Based Tuberculosis Isolation Decisions Require Individualization Based on Effectiveness and Duration of Treatment, Community Risks, and Patient Harms.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. ISCCM Position Statement on the Approach to and Management of Critically Ill Patients with Tuberculosis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024
    Article

24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

A S DharmadhikariDivision of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
M MphahleleSouth African Medical Research Council, Pretoria, South Africa.
K VenterSouth African Medical Research Council, Pretoria, South Africa.
A StoltzUniversity of Pretoria, Pretoria, South Africa.
R MathebulaSouth African Medical Research Council, Pretoria, South Africa.
T MasotlaSouth African Medical Research Council, Pretoria, South Africa.
M van der WaltSouth African Medical Research Council, Pretoria, South Africa.
M PaganoDepartment of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.
P JensenCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
E NardellDivision of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
South African Medical Research Council · ZABrigham and Women's Hospital · USCenters for Disease Control and Prevention · USHarvard University · USUniversity of Pretoria · ZA

Funding

Testing Novel Interventions to Protect Workers from Airborne InfectionsR01OH009050 · OH · BRIGHAM AND WOMEN'S HOSPITAL · PI NARDELL, EDWARD A. · 2006 to 2015
$3.5M
NIOSH CDC HHS R01 OH009050NIOSH CDC HHS R01OH009050
6 · The paper itself

Abstract

backgroundEffective treatment for drug-susceptible tuberculosis (TB) rapidly renders patients non-infectious, long before conversion of sputum acid-fast smear or culture to negative. Multidrug-resistant TB (MDR-TB) patients on treatment are currently assumed to remain infectious for months. While the resources required for prolonged hospitalization are a barrier to the scale-up of MDR-TB treatment, the safety of community treatment is clear.

objectivesTo estimate the impact of treatment on infectiousness among MDR-TB patients.

methodsA series of five human-to-guinea pig TB transmission studies was conducted to test various interventions for infection control. Guinea pigs in adjacent chambers were exposed to exhaust air from a hospital ward occupied by mostly sputum smear- and culture-positive MDR-TB patients. The guinea pigs then underwent tuberculin skin testing for infection. Only the control groups of guinea pigs from each study (no interventions used) provide the data for this analysis. The number of guinea pigs infected in each study is reported and correlated with Mycobacterium tuberculosis drug susceptibility relative to treatment.

resultsDespite exposure to presumably infectious MDR-TB patients, infection percentages among guinea pigs ranged from 1% to 77% in the five experiments conducted. In one experiment in which guinea pigs were exposed to 27 MDR-TB patients newly started on effective treatment for 3 months, there was minimal transmission. In four other experiments with greater transmission, guinea pigs had been exposed to patients with unsuspected extensively drug-resistant tuberculosis who were not on effective treatment.

conclusionsIn this model, effective treatment appears to render MDR-TB patients rapidly non-infectious. Further prospective studies on this subject are needed.

Indexed as

Air MicrobiologyAdolescentAdultAgedAnimalsAntitubercular AgentsCross InfectionExtensively Drug-Resistant TuberculosisFemaleGuinea PigsHumansInfection ControlMaleMicrobial Sensitivity TestsMiddle AgedMycobacterium tuberculosisAntitubercular Agents

Identifiers

PMID25189547
PMCPMC4692272
OpenAlexW2121562380

What OpenQuestion holds

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LicenceTDM
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.