TY - JOUR
T1 - Molecular epidemiology of tuberculosis in Havana, Cuba, 2009
AU - González Díaz, Alexander
AU - Battaglioli, Tullia
AU - Díaz Rodríguez, Raúl
AU - Goza Valdés, Roxana
AU - González Ochoa, Edilberto
AU - Van der Stuyft, Patrick
N1 - © 2015 John Wiley & Sons Ltd.
PY - 2015
Y1 - 2015
N2 - OBJECTIVES: To estimate the proportion of tuberculosis cases attributable to recent transmission and the risk factors possibly associated with tuberculosis clustering.METHODS: Population-based study combining information from epidemiological investigation of tuberculosis cases notified to the National Tuberculosis Control Program in Havana, Cuba, in 2009 with the results of genotyping of Mycobacterium tuberculosis isolates with variable number tandem repeat of mycobacterial interspersed repetitive units (MIRU-VNTR) typing.RESULTS: Of 186 cases, 61 were genotyped: 33 patterns and five clusters with 19, 7, 3, 2 and 2 cases were found. The proportion of cases due to recent transmission was 45% (95% confidence interval 33-58%). Routine contact investigation failed to identify a substantial number of epidemiological links. A history of living in a closed setting was strongly associated with clustering.CONCLUSIONS: The proportion of cases due to recent transmission in Havana in 2009 is high. The existing control measures in closed settings should be strengthened. A study on a larger number of cases and for a longer time period should be carried out to obtain more precise estimates. Further studies on the utility and cost-effectiveness of the addition of molecular epidemiology techniques to support the progress towards tuberculosis elimination in Cuba, a low-incidence resource-limited setting, are also needed.
AB - OBJECTIVES: To estimate the proportion of tuberculosis cases attributable to recent transmission and the risk factors possibly associated with tuberculosis clustering.METHODS: Population-based study combining information from epidemiological investigation of tuberculosis cases notified to the National Tuberculosis Control Program in Havana, Cuba, in 2009 with the results of genotyping of Mycobacterium tuberculosis isolates with variable number tandem repeat of mycobacterial interspersed repetitive units (MIRU-VNTR) typing.RESULTS: Of 186 cases, 61 were genotyped: 33 patterns and five clusters with 19, 7, 3, 2 and 2 cases were found. The proportion of cases due to recent transmission was 45% (95% confidence interval 33-58%). Routine contact investigation failed to identify a substantial number of epidemiological links. A history of living in a closed setting was strongly associated with clustering.CONCLUSIONS: The proportion of cases due to recent transmission in Havana in 2009 is high. The existing control measures in closed settings should be strengthened. A study on a larger number of cases and for a longer time period should be carried out to obtain more precise estimates. Further studies on the utility and cost-effectiveness of the addition of molecular epidemiology techniques to support the progress towards tuberculosis elimination in Cuba, a low-incidence resource-limited setting, are also needed.
KW - B680-public-health
KW - Tuberculosis
U2 - 10.1111/tmi.12569
DO - 10.1111/tmi.12569
M3 - A1: Web of Science-article
C2 - 26211409
VL - 20
SP - 1534
EP - 1542
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
SN - 1360-2276
IS - 11
ER -