Multidrug-resistant tuberculosis: household transmission and associated risk factors

Given the global burden of tuberculosis, and more precisely of multidrug-resistant (MDR) tuberculosis (TB), one of the most pressing epidemiological issues is the study and prevention of transmission. The study aims to assess transmission within households that present at least two cases of MDR-TB and the possible risk factors, from MDR-TB isolates collected in Lima, Peru and further characterized by genotyping methods, spoligotyping and mycobacterial interspersed repetitive units (MIRU) - variable number tandem repeat (VNTR), used for DNA fingerprinting. Apart from the genotyping results, the data set also provides the drug susceptibility testing (DST) profile for each isolate, as well as information on the households and the patients. The key assumption to transform molecular data into epidemiological data is that all identical isolates are classified in the same cluster, the cluster belong to a unique strain of tuberculosis, and a unique strain infecting more than one individual is presumed to be the result of direct transmission. The analysis is divided in two parts, first the establishment of household transmission or outside transmission for each isolate and then the following epidemiological analysis; and requires the use of Matlab and Stata software. The main results are the cohort characteristics, the concordance between the two genotyping methods, the clusters' composition and size frequency, the transmission analysis, the amplification of resistance analysis and the risk factors analysis for household transmission. From there, the main findings are the high rate of household transmission (more than 80%) of the isolates and drug resistance amplification (up to 10 new resisitances within one household clustered strain). The risk factor analysis did not present any significant results, but a few trends that are worth to explore in the future

Cole, Stewart
Laboratory of Prof. Megan Murray, Harvard School of Public Health


 Record created 2010-11-23, last modified 2018-01-28

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