Dataset Information

Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes.

ABSTRACT: The aims of the study were: (1) compare sociodemographic characteristics among active tuberculosis (TB) cases and their household contacts in cold and hot spot transmission areas, and (2) quantify the influence of locality, genotype and potential determinants on the rates of latent tuberculosis infection (LTBI) among household contacts of index TB cases. Parallel case-contact studies were conducted in two geographic areas classified as "cold" and "hot" spots based on TB notification and spatial clustering between January and June 2018 in Guangxi, China, using data from field contact investigations, whole genome sequencing, tuberculin skin tests (TSTs), and chest radiographs. Beijing family strains accounted for 64.6% of Mycobacterium tuberculosis (Mtb) strains transmitted in hot spots, and 50.7% in cold spots (p-value = 0.02). The positive TST rate in hot spot areas was significantly higher than that observed in cold spot areas (p-value < 0.01). Living in hot spots (adjusted odds ratio (aOR) = 1.75, 95%, confidence interval (CI): 1.22, 2.50), Beijing family genotype (aOR = 1.83, 95% CI: 1.19, 2.81), living in the same room with an index case (aOR = 2.29, 95% CI: 1.5, 3.49), travelling time from home to a medical facility (aOR = 4.78, 95% CI: 2.96, 7.72), history of Bacillus Calmette-Guérin vaccination (aOR = 2.02, 95% CI: 1.13 3.62), and delay in diagnosis (aOR = 2.56, 95% CI: 1.13, 5.80) were significantly associated with positive TST results among household contacts of TB cases. The findings of this study confirmed the strong transmissibility of the Beijing genotype family strains and this genotype's important role in household transmission. We found that an extended traveling time from home to the medical facility was an important socioeconomic factor for Mtb transmission in the family. It is still necessary to improve the medical facility infrastructure and management, especially in areas with a high TB prevalence.

SUBMITTER: Cui Z

PROVIDER: S-EPMC6572207 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and <i>Mycobacterium tuberculosis</i> Genotypes.

Cui Zhezhe Z Lin Dingwen D Chongsuvivatwong Virasakdi V Graviss Edward A EA Chaiprasert Angkana A Palittapongarnpim Prasit P Lin Mei M Ou Jing J Zhao Jinming J

International journal of environmental research and public health 20190527 10

The aims of the study were: (1) compare sociodemographic characteristics among active tuberculosis (TB) cases and their household contacts in cold and hot spot transmission areas, and (2) quantify the influence of locality, genotype and potential determinants on the rates of latent tuberculosis infection (LTBI) among household contacts of index TB cases. Parallel case-contact studies were conducted in two geographic areas classified as "cold" and "hot" spots based on TB notification and spatial ...[more]

PMID: 31137811

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Project description:BACKGROUND:Understanding the geographical distribution of multidrug-resistant tuberculosis (MDR-TB) in high TB burden countries such as Ethiopia is crucial for effective control of TB epidemics in these countries, and thus globally. We present the first spatial analysis of multidrug resistant tuberculosis, and its relationship to socio-economic, demographic and household factors in northwest Ethiopia. METHODS:An ecological study was conducted using data on patients diagnosed with MDR-TB at the University of Gondar Hospital MDR-TB treatment centre, for the period 2010 to 2015. District level population data were extracted from the Ethiopia National and Regional Census Report. Spatial autocorrelation was explored using Moran's I statistic, Local Indicators of Spatial Association (LISA), and the Getis-Ord statistics. A multivariate Poisson regression model was developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian Markov chain Monte Carlo (MCMC) simulation approach with Gibbs sampling, in WinBUGS. RESULTS:A total of 264 MDR-TB patients were included in the analysis. The overall crude incidence rate of MDR-TB for the six-year period was 3.0 cases per 100,000 population. The highest incidence rate was observed in Metema (21 cases per 100,000 population) and Humera (18 cases per 100,000 population) districts; whereas nine districts had zero cases. Spatial clustering of MDR-TB was observed in districts located in the Ethiopia-Sudan and Ethiopia-Eritrea border regions, where large numbers of seasonal migrants live. Spatial clustering of MDR-TB was positively associated with urbanization (RR: 1.02; 95%CI: 1.01, 1.04) and the percentage of men (RR: 1.58; 95% CI: 1.26, 1.99) in the districts; after accounting for these factors there was no residual spatial clustering. CONCLUSION:Spatial clustering of MDR-TB, fully explained by demographic factors (urbanization and percent male), was detected in the border regions of northwest Ethiopia, in locations where seasonal migrants live and work. Cross-border initiatives including options for mobile TB treatment and follow up are important for the effective control of MDR-TB in the region.

Project description:BackgroundHousehold food and nutrition insecurity continued to be a development and policy agenda in Ethiopia. Assessing the patterns and determinants of household dietary diversity is an important area of research given its importance for policy uptake in the country. This study is, therefore, initiated to identify the dominant food groups consumed by households and to investigate the determinants of household dietary diversity in the country.MethodWe used data from the 4th wave of the Ethiopian socioeconomic survey. The survey data for this study included 3,115 households living in rural areas (hereafter called 'rural households'). Household Dietary Diversity Score (HDDS) was calculated and categorized as per the FAO's recommendation: low HDDS category for those who consume three or less food groups, medium HDDS for those who consume four to six, and high HDDS for those who consume seven and more food groups during the past seven days. Ordinal logistic regression model was employed to estimate the determinants of rural household's dietary diversity.ResultsCereals were the most dominant food group consumed by 96.4% of the households followed by pulses, which was consumed by 82% of the households Nutrition-dense food commodities such as lean meat, vegetables and fruits were the least consumed food groups by households in Ethiopia. In terms of determinants of dietary diversity, female headed households have 38% more chance of consuming diverse foods compared to their male-headed counterparts (AOR = 1.38, 95% CI: 1.10, 1.73). Household heads who completed secondary education and above have 62% more chance of consuming diverse foods compared to uneducated household heads (AOR = 1.62, 95% CI: 1.2, 2.30). Household heads who are single have 37% less chance of consuming diverse foods compared to those household heads who are married (AOR = 0.63, 95% CI: 0.50, 0.80). Those households located in Harari regional state and in the rural surroundings of Diredawa town have 6.56 times more chance of consuming diverse foods compared to those households living in Tigray and Amhara regional states (AOR = 6.56, 95% CI: 4.60, 9.37). The results also highlighted that households who are in the upper wealth category have 9 times more chance of consuming diverse foods compared to those households who are the lower wealth category (AOR = 8.54, 95% CI: 6.79, 11.98).

Dataset Information

Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes.

Publications

Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and <i>Mycobacterium tuberculosis</i> Genotypes.

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