ArticleThe Lancet. Infectious diseases2018
Internal migration and transmission dynamics of tuberculosis in Shanghai, China: an epidemiological, spatial, genomic analysis.
Article in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 4 of them syntheses that pooled it.
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Who cites it
81 citing papers in PubMed, 4 syntheses or guidelines pooled it, 133 citations in OpenAlex.
- Urban and rural prevalence of tuberculosis in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Active Case Finding for Tuberculosis in Migrants: a Systematic Review.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Pooled it
- Reporting practices for genomic epidemiology of tuberculosis: a systematic review of the literature using STROME-ID guidelines as a benchmark.The Lancet. Microbe · 2021Pooled it
- Spatially targeted screening to reduce tuberculosis transmission in high-incidence settings.The Lancet. Infectious diseases · 2019Pooled it
- Quantifying the community transmission ofEmerging microbes & infections · 2026Article
- Article
- Spatiotemporal trends in tuberculosis incidence in Thailand, 2012-2023: a nationwide, province-level analysis.Infectious diseases of poverty · 2026Article
- Using genomic epidemiology and geographic activity spaces to investigate tuberculosis outbreaks in Botswana.International journal of health geographics · 2026Article
- Identification of tuberculosis transmission hotspots in urban China using surveillance data: a machine learning approach based on genomic and spatial analysis.BMC infectious diseases · 2026Article
- Spatiotemporal patterns, associated factors, and forecasting of pulmonary tuberculosis: a 19-year township-level case study in Zigong City, China.BMC public health · 2026Article
- Transmission dynamics and attributable burden of tuberculosis among young and middle-aged adults in urban Shanghai: a genomic epidemiology study.Frontiers in public health · 2026Article
- Whole genome sequencing to characterize the molecular epidemiology and drug-resistance of tuberculosis in Huzhou, China.BMC genomics · 2025Article
- Molecular Epidemiology of Mycobacterium tuberculosis Across 3 Distinct Geographic Sites in South Africa.The Journal of infectious diseases · 2025Article
- Integrating genomic and spatial analyses to describe tuberculosis transmission: a scoping review.The Lancet. Microbe · 2025Article
- Social participation and exposure to tuberculosis education: a cross-sectional study of older (≥ 60 years) domestic migrants in China.BMC public health · 2025Article
- Bayesian estimation of transmission networks for infectious diseases.Journal of mathematical biology · 2025Article
- Global epidemiology of Mycobacterium tuberculosis lineage 4 insights from Ecuadorian genomic data.Scientific reports · 2025Article
- Analysis of diagnosis delay among migrant pulmonary tuberculosis patients in Guangzhou from 2014 to 2022.Frontiers in public health · 2025Article
- Epidemiology and Molecular Drug-Resistance Patterns of Tuberculosis in Non-Elderly Patients in Luoyang, China, 2019-2023.Infection and drug resistance · 2025Article
- Distribution and transmission of M. tuberculosis in a high-HIV prevalence city in Malawi: A genomic and spatial analysis.PLOS global public health · 2025Article
21 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundMassive internal migration from rural to urban areas poses new challenges for tuberculosis control in China. We aimed to combine genomic, spatial, and epidemiological data to describe the dynamics of tuberculosis in an urban setting with large numbers of migrants.
methodsWe did a population-based study of culture-positive Mycobacterium tuberculosis isolates in Songjiang, Shanghai. We used whole-genome sequencing to discriminate apparent genetic clusters of M tuberculosis sharing identical variable-number-tandem-repeat (VNTR) patterns, and analysed the relations between proximity of residence and the risk of genomically clustered M tuberculosis. Finally, we used genomic, spatial, and epidemiological data to estimate time of infection and transmission links among migrants and residents.
findingsBetween Jan 1, 2009, and Dec 31, 2015, 1620 cases of culture-positive tuberculosis were recorded, 1211 (75%) of which occurred among internal migrants. 150 (69%) of 218 people sharing identical VNTR patterns had isolates within ten single-nucleotide polymorphisms (SNPs) of at least one other strain, consistent with recent transmission of M tuberculosis. Pairs of strains collected from individuals living in close proximity were more likely to be genetically similar than those from individuals who lived far away-for every additional km of distance between patients' homes, the odds that genotypically matched strains were within ten SNPs of each other decreased by about 10% (OR 0·89 [95% CI 0·87-0·91]; p<0·0001). We inferred that transmission from residents to migrants occurs as commonly as transmission from migrants to residents, and we estimated that more than two-thirds of migrants in genomic clusters were infected locally after migration.
interpretationThe primary mechanism driving local incidence of tuberculosis in urban centres is local transmission between both migrants and residents. Combined analysis of epidemiological, genomic, and spatial data contributes to a richer understanding of local transmission dynamics and should inform the design of more effective interventions.
fundingNational Natural Science Foundation of China, National Science and Technology Major Project of China, and US National Institutes of Health.
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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.