ArticlePloS one2018
Spatial overlap links seemingly unconnected genotype-matched TB cases in rural Uganda.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of spatially targeted interventions for control of HIV, tuberculosis, leprosy and malaria: a systematic review.BMJ open · 2021Pooled it
- Integrating genomic and spatial analyses to describe tuberculosis transmission: a scoping review.The Lancet. Microbe · 2025Article
- Mobility patterns, activity locations, and TB in Nairobi, Kenya.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
- Blurring cluster randomized trials and observational studies: Two-Stage TMLE for subsampling, missingness, and few independent units.Biostatistics (Oxford, England) · 2024Article
- Airway microbiome signature accurately discriminatesiScience · 2024Article
- Identification of Risk Factors Associated with Tuberculosis in Southwest Iran: A Machine Learning Method.Medical journal of the Islamic Republic of Iran · 2024Article
- Deep learning and social network analysis elucidate drivers of HIV transmission in a high-incidence cohort of people who inject drugs.Science advances · 2022Article
- Geospatial analysis of reported activity locations to identify sites for tuberculosis screening.Scientific reports · 2022Article
- Patterns of Childhood Tuberculosis Diagnosis in Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama Regional State, Ethiopia.Pediatric health, medicine and therapeutics · 2022Article
- Community transmission of multidrug-resistant tuberculosis is associated with activity space overlap in Lima, Peru.BMC infectious diseases · 2021Article
- Spatial analysis of HIV-TB co-clustering in Uganda.BMC infectious diseases · 2019Article
- A Case-Control Study to Identify Community Venues Associated with Genetically-clustered, Multidrug-resistant Tuberculosis Disease in Lima, Peru.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
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11 authors.
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Abstract
introductionIncomplete understanding of TB transmission dynamics in high HIV prevalence settings remains an obstacle for prevention. Understanding where transmission occurs could provide a platform for case finding and interrupting transmission.
methodsFrom 2012-2015, we sought to recruit all adults starting TB treatment in a Ugandan community. Participants underwent household (HH) contact investigation, and provided names of social contacts, sites of work, healthcare and socializing, and two sputum samples. Mycobacterium tuberculosis culture-positive specimens underwent 24-loci MIRU-VNTR and spoligotyping. We sought to identify epidemiologic links between genotype-matched cases by analyzing social networks and mapping locations where cases reported spending ≥12 hours over the one-month pre-treatment. Sites of spatial overlap (≤100m) between genotype-matched cases were considered potential transmission sites. We analyzed social networks stratified by genotype clustering status, with cases linked by shared locations, and compared network density by location type between clustered vs. non-clustered cases.
resultsOf 173 adults with TB, 131 (76%) were enrolled, 108 provided sputum, and 84/131 (78%) were MTB culture-positive: 52% (66/131) tested HIV-positive. Of 118 adult HH contacts, 105 (89%) were screened and 3 (2.5%) diagnosed with active TB. Overall, 33 TB cases (39%) belonged to 15 distinct MTB genotype-matched clusters. Within each cluster, no cases shared a HH or reported shared non-HH contacts. In 6/15 (40%) clusters, potential epidemiologic links were identified by spatial overlap at specific locations: 5/6 involved health care settings. Genotype-clustered TB social networks had significantly greater network density based on shared clinics (p<0.001) and decreased density based on shared marketplaces (p<0.001), compared to non-clustered networks.
conclusionsIn this molecular epidemiologic study, links between MTB genotype-matched cases were only identifiable via shared locations, healthcare locations in particular, rather than named contacts. This suggests most transmission is occurring between casual contacts, and emphasizes the need for improved infection control in healthcare settings in rural Africa.
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