i
Tuberculosis Genotype Clusters and Transmission in the U.S., 2009–2018
-
8 2021
-
-
Source: Am J Prev Med. 61(2):201-208
[PDF-539.87 KB]
Details:
-
Alternative Title:Am J Prev Med
-
Personal Author:
-
Description:Introduction:
In the U.S., universal genotyping of culture-confirmed tuberculosis cases facilitates cluster detection. Early recognition of the small clusters more likely to become outbreaks can help prioritize public health resources for immediate interventions.
Methods:
This study used national surveillance data reported during 2009–2018 to describe incident clusters (≥3 tuberculosis cases with matching genotypes not previously reported in the same county); data were analyzed during 2020. Cox proportional hazards regression models were used to examine patient characteristics associated with clusters doubling in size to ≥6 cases.
Results:
During 2009–2018, a total of 1,516 incident clusters (comprising 6,577 cases) occurred in 47 U.S. states; 231 clusters had ≥6 cases. Clusters of ≥6 cases disproportionately included patients who used substances, had recently experienced homelessness, were incarcerated, were U.S.-born, or self-identified as of American Indian or Alaska Native race or of Black race. A median of 54 months elapsed between the first and third cases in clusters that remained at 3–5 cases, compared with 9.5 months in clusters that grew to ≥6 cases. Longer time between first and third cases and presence of ≥1 patient aged ≥65 years among the first 3 cases predicted lower hazard for accumulating ≥6 cases.
Conclusions:
Clusters accumulating ≥3 cases within a year should be prioritized for intervention. Effective responses strategies should include plans for targeted outreach to U.S.-born individuals, incarcerated people, those experiencing homelessness, people using substances, and individuals self-identifying as of American Indian or Alaska Native race or of Black race.
-
Subjects:
-
Source:
-
Pubmed ID:33992497
-
Pubmed Central ID:PMC9254502
-
Document Type:
-
Funding:
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
