ArticleThe Lancet. Respiratory medicine2015
Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis.
Article in The Lancet. Respiratory medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 5 of them syntheses that pooled it.
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Who cites it
121 citing papers in PubMed, 5 syntheses or guidelines pooled it, 232 citations in OpenAlex.
- Association between HIV and acquisition of rifamycin resistance with first-line TB treatment: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2021Pooled it
- Population-level mathematical modeling of antimicrobial resistance: a systematic review.BMC medicine · 2019Pooled it
- Time to treatment for rifampicin-resistant tuberculosis: systematic review and meta-analysis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Pooled it
- 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 · 2017Pooled it
- Article
- Transmission of rifampicin-resistant tuberculosis in Ho Chi Minh City, Viet Nam: a prospective genomic epidemiology study.The Lancet regional health. Western Pacific · 2026Article
- The global phylogeography of rapidly expanding multidrug resistant Ural lineage 4.2 Mycobacterium tuberculosis.Nature communications · 2026Article
- Preventing Multidrug-Resistant Tuberculosis: The Dawn of a New Era.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- From clinical phenotypes to genomic signatures: machine learning integration for precision tuberculosis treatment prediction.Frontiers in bioinformatics · 2026Article
- Barriers and facilitators to implementing an integrated electronic health records system to improve tuberculosis preventive treatment among people living with HIV: a content analysis study from Georgia.Frontiers in digital health · 2026Article
- Extensive Endemic Transmission of Multidrug-ResistantOpen forum infectious diseases · 2026Article
- Impact of HIV and hospitalization on the incidence of subsequent rifampicin-resistant tuberculosis after initiation of first-line tuberculosis treatment: a retrospective cohort study in South Africa.EClinicalMedicine · 2025Article
- Whole genome sequencing for tuberculosis disease species identification, lineage determination, and drug resistance detection in Kashgar prefecture, China.BMC infectious diseases · 2025Article
- Sentinel-Site-Based Surveillance ofAntibiotics (Basel, Switzerland) · 2025Article
- Impact of sublineage diversity on intrinsic susceptibility of Beijing genotype Mycobacterium tuberculosis.Annals of clinical microbiology and antimicrobials · 2025Article
- The Identification of Novel Mutations in ATP-Dependent Protease ClpC1 Assists in the Molecular Diagnosis of Obscured Pyrazinamide-Resistant Tuberculosis Clinical Isolates.Microorganisms · 2025Article
- Article
- Multi-drug resistance and compensatory mutations in Mycobacterium tuberculosis in Vietnam.Tropical medicine & international health : TM & IH · 2025Article
- Advantages of updated WHO mutation catalog combined with existing whole-genome sequencing-based approaches for Mycobacterium tuberculosis resistance prediction.Genome medicine · 2025Article
61 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMultidrug-resistant (MDR) tuberculosis can be acquired through de-novo mutation during tuberculosis treatment or through transmission from other individuals with active MDR tuberculosis. Understanding the balance between these two mechanisms is essential when allocating resources for MDR tuberculosis. We aimed to create a dynamic transmission model of an MDR tuberculosis epidemic to estimate the contributions of treatment-related acquisition and person-to-person transmission of resistance to incident MDR tuberculosis cases.
methodsIn this modelling analysis, we constructed a dynamic transmission model of an MDR tuberculosis epidemic, allowing for both treatment-related acquisition and person-to-person transmission of resistance. We used national tuberculosis notification data to inform Bayesian estimates of the proportion of each country's 2013 MDR tuberculosis incidence that resulted from MDR transmission rather than treatment-related MDR acquisition.
findingsGlobal estimates of 3·5% MDR tuberculosis prevalence among new tuberculosis notifications and 20·5% among re-treatment notifications translate into an estimate that resistance transmission rather than acquisition accounts for a median 95·9% (95% uncertainty range [UR] 68·0-99·6) of all incident MDR tuberculosis, and 61·3% (16·5-95·2) of incident MDR tuberculosis in previously treated individuals. The estimated proportion of MDR tuberculosis resulting from transmission varied substantially with different countries' notification data-ranging from 48% (95% UR 30-75) in Bangladesh to 99% (91-100) in Uzbekistan. Estimates were most sensitive to estimates of the transmissibility of MDR strains, the probability of acquiring MDR during tuberculosis treatment, and the responsiveness of MDR tuberculosis to first-line treatment.
interpretationNotifications of MDR prevalence from most high-burden settings are consistent with most incident MDR tuberculosis resulting from transmission rather than new treatment-related acquisition of resistance. Merely improving the treatment of drug-susceptible tuberculosis is unlikely to greatly reduce future MDR tuberculosis incidence. Improved diagnosis and treatment of MDR tuberculosis-including new tests and drug regimens-should be highly prioritised.
fundingNational Institutes of Health and the Bill & Melinda Gates Foundation.
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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.