Where is tuberculosis transmission happening? Insights from the literature, new tools to study transmission and implications for the elimination of tuberculosis

Details

• Alternative Title:
  Respirology
• Personal Author:
  AULD, Sara C. ; SHAH, N. Sarita ; COHEN, Ted ; MARTINSON, Neil A. ; GANDHI, Neel R.
• Description:
  More than 10 million new cases of tuberculosis (TB) are diagnosed worldwide each year. The majority of these cases occur in low- and middle-income countries where the TB epidemic is predominantly driven by transmission. Efforts to 'end TB' will depend upon our ability to halt ongoing transmission. However, recent studies of new approaches to interrupt transmission have demonstrated inconsistent effects on reducing population-level TB incidence. TB transmission occurs across a wide range of settings, that include households and hospitals, but also community-based settings. While home-based contact investigations and infection control programmes in hospitals and clinics have a successful track record as TB control activities, there is a gap in our knowledge of where, and between whom, community-based transmission of TB occurs. Novel tools, including molecular epidemiology, geospatial analyses and ventilation studies, provide hope for improving our understanding of transmission in countries where the burden of TB is greatest. By integrating these diverse and innovative tools, we can enhance our ability to identify transmission events by documenting the opportunity for transmission-through either an epidemiologic or geospatial connection-alongside genomic evidence for transmission, based upon genetically similar TB strains. A greater understanding of locations and patterns of transmission will translate into meaningful improvements in our current TB control activities by informing targeted, evidence-based public health interventions.
• Subjects:
  Article Epidemiology Molecular Epidemiology Public Health Tuberculosis
• Source:
  Respirology.
• Pubmed ID:
  29869818
• Pubmed Central ID:
  PMC6281783
• Document Type:
  Journal Article
• Funding:
  U19 AI111211/AI/NIAID NIH HHS/United States ; P30 AI050409/AI/NIAID NIH HHS/United States ; K23 AI134182/AI/NIAID NIH HHS/United States ; R01 AI138646/AI/NIAID NIH HHS/United States ; R01 AI089349/AI/NIAID NIH HHS/United States ; CC999999/Intramural CDC HHS/United States ; R01 AI087465/AI/NIAID NIH HHS/United States ; R01 AI112438/AI/NIAID NIH HHS/United States ; K24 AI114444/AI/NIAID NIH HHS/United States
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8bb98b3561054e643493f84ff331fa99d9d44cbd5ee9e1c00be2bd9e175eb7a3
• Download URL:
  https://stacks.cdc.gov/view/cdc/61236/cdc_61236_DS1.pdf
• File Type:
  [PDF - 688.79 KB ]