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TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa

dc.contributor.authorTadokera, Rebeccaen_ZA
dc.contributor.authorBekker, Linda-Gailen_ZA
dc.contributor.authorKreiswirth, Barry N.en_ZA
dc.contributor.authorMathema, Barunen_ZA
dc.contributor.authorMiddelkoop, Kerenen_ZA
dc.date.accessioned2020-02-17T05:13:59Z
dc.date.available2020-02-17T05:13:59Z
dc.date.issued2020-02-10
dc.identifier.citationTadokera, R., et al. 2020. TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa. BMC Infectious Diseases, 20:120, doi:10.1186/s12879-020-4828-z
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi:10.1186/s12879-020-4828-z
dc.identifier.urihttp://hdl.handle.net/10019.1/107487
dc.descriptionCITATION: Tadokera, R., et al. 2020. TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa. BMC Infectious Diseases, 20:120, doi:10.1186/s12879-020-4828-z.
dc.descriptionThe original publication is available at https://bmcinfectdis.biomedcentral.com
dc.description.abstractBackground: While several studies have assessed the associations between biological factors and tuberculosis (TB) transmission, our understanding of the associations between TB transmission and social and economic factors remains incomplete. We aimed to explore associations between community TB transmission and socio-economic factors within a high TB-HIV burdened setting. Methods: We conducted a cross-sectional molecular epidemiology study among adult patients attending a routine TB clinic. Demographic and clinical data were extracted from TB registers and clinical folders; social and economic data were collected using interviewer-administered questionnaires; Mycobacterium tuberculosis isolates were genotyped and classified as clustered/non-clustered using IS6110-based Restriction Fragment Length Polymorphism. Composite “social” and “economic” scores were generated from social and economic data. Data were analyzed using StataCorp version 15.0 software. Stratified, bivariable analyses were performed using chisquared. Wilcoxon signed rank tests; univariable and multivariable logistic regression models were developed to explore associations in the social, economic, traditional and composite TB risk factors with TB transmission. Results: Of the 505 patient Mtb strains, 348(69%) cases were classified as clustered and 157(31%) were nonclustered. Clustered cases were more likely to have lived longer in the study community, (odds ratio [OR] = 1.05, 95% Confidence interval [C.I]:1.02–1.09, p = 0.006); in the same house (OR = 1.04, C.I: 0.99–1.08, p = 0.06); and had increased household crowding conditions (i.e fewer rooms used for sleeping, OR = 0.45, C.I:0.21–0.95, p = 0.04). Although a higher proportion of clustered cases had a low economic score, no statistically significant association was found between clustering and either the economic score (p = 0.13) or social score (p = 0.26). Conclusions: We report a novel association between Mtb transmission and prolonged stay within a high burdened community. Transmission was also associated with fewer rooms for sleeping in a household. Increased social interaction and prolonged residence in a high burdened community are important factors linked to Mtb transmission, possibly due to increased probability of higher effective contact rates. The possible importance of degrees of poverty within low socio-economic setting warrants further study.en_ZA
dc.description.urihttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-4828-z
dc.format.extent9 pages ; illustrations
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.subjectTuberculosis -- Transmission -- Cape Town (South Africa)
dc.subjectTuberculosis -- Transmission -- Developing countriesen_ZA
dc.subjectTuberculosis -- Patients -- Cape Town (South Africa)en_ZA
dc.subjectHIV-positive persons -- Cape Town (South Africa)en_ZA
dc.titleTB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africaen_ZA
dc.typeArticle
dc.date.updated2020-02-16T04:22:23Z
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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