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Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data

التفاصيل البيبلوغرافية
العنوان: Multiple large clusters of tuberculosis in London: a cross-sectional analysis of molecular and spatial data
المؤلفون: Catherine M. Smith, Helen Maguire, Charlotte Anderson, Neil Macdonald, Andrew C. Hayward
المصدر: ERJ Open Research, Vol 3, Iss 1 (2017)
بيانات النشر: European Respiratory Society, 2017.
سنة النشر: 2017
المجموعة: LCC:Medicine
مصطلحات موضوعية: Medicine
الوصف: Large outbreaks of tuberculosis (TB) represent a particular threat to disease control because they reflect multiple instances of active transmission. The extent to which long chains of transmission contribute to high TB incidence in London is unknown. We aimed to estimate the contribution of large clusters to the burden of TB in London and identify risk factors. We identified TB patients resident in London notified between 2010 and 2014, and used 24-locus mycobacterial interspersed repetitive units–variable number tandem repeat strain typing data to classify cases according to molecular cluster size. We used spatial scan statistics to test for spatial clustering and analysed risk factors through multinomial logistic regression. TB isolates from 7458 patients were included in the analysis. There were 20 large molecular clusters (with n>20 cases), comprising 795 (11%) of all cases; 18 (90%) large clusters exhibited significant spatial clustering. Cases in large clusters were more likely to be UK born (adjusted odds ratio 2.93, 95% CI 2.28–3.77), of black-Caribbean ethnicity (adjusted odds ratio 3.64, 95% CI 2.23–5.94) and have multiple social risk factors (adjusted odds ratio 3.75, 95% CI 1.96–7.16). Large clusters of cases contribute substantially to the burden of TB in London. Targeting interventions such as screening in deprived areas and social risk groups, including those of black ethnicities and born in the UK, should be a priority for reducing transmission.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2312-0541
23120541
Relation: http://openres.ersjournals.com/content/3/1/00098-2016.full; https://doaj.org/toc/2312-0541
DOI: 10.1183/23120541.00098-2016
URL الوصول: https://doaj.org/article/3f37945e30aa464db01e3ea36a29a26c
رقم الانضمام: edsdoj.3f37945e30aa464db01e3ea36a29a26c
قاعدة البيانات: Directory of Open Access Journals
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