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.author | Tadokera, Rebecca | |
| dc.contributor.author | Bekker, Linda-Gail | |
| dc.contributor.author | Kreiswirth, Barry N | |
| dc.contributor.author | Mathema, Barun | |
| dc.contributor.author | Middelkoop, Keren | |
| dc.date.accessioned | 2020-02-18T10:26:51Z | |
| dc.date.available | 2020-02-18T10:26:51Z | |
| dc.date.issued | 2020-02-10 | |
| dc.date.updated | 2020-02-16T04:47:57Z | |
| dc.description.abstract | Abstract Background 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 chi-squared. 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 non-clustered. 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. | |
| dc.identifier.apacitation | Tadokera, R., Bekker, L., Kreiswirth, B. N., Mathema, B., & Middelkoop, K. (2020). TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/31155 | en_ZA |
| dc.identifier.chicagocitation | Tadokera, Rebecca, Linda-Gail Bekker, Barry N Kreiswirth, Barun Mathema, and Keren Middelkoop "TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa." <i>BMC Infectious Diseases</i> (2020) http://hdl.handle.net/11427/31155 | en_ZA |
| dc.identifier.citation | Tadokera, R., Bekker, L. G., Kreiswirth, B. N., Mathema, B., & Middelkoop, K. (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(1), 120. | |
| dc.identifier.ris | TY - AU - Tadokera, Rebecca AU - Bekker, Linda-Gail AU - Kreiswirth, Barry N AU - Mathema, Barun AU - Middelkoop, Keren AB - Abstract Background 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 chi-squared. 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 non-clustered. 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. DA - 2020-02-10 DB - OpenUCT DP - University of Cape Town J1 - BMC Infectious Diseases KW - Tuberculosis KW - TB transmission KW - Clustering KW - Socio-economic status KW - RFLP KW - Molecular epidemiology LK - https://open.uct.ac.za PY - 2020 T1 - TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa TI - TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa UR - http://hdl.handle.net/11427/31155 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12879-020-4828-z | |
| dc.identifier.uri | http://hdl.handle.net/11427/31155 | |
| dc.identifier.vancouvercitation | Tadokera R, Bekker L, Kreiswirth BN, Mathema B, Middelkoop K. 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. 2020; http://hdl.handle.net/11427/31155. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.rights.holder | The Author(s). | |
| dc.source | BMC Infectious Diseases | |
| dc.source.uri | https://bmcinfectdis.biomedcentral.com/ | |
| dc.subject | Tuberculosis | |
| dc.subject | TB transmission | |
| dc.subject | Clustering | |
| dc.subject | Socio-economic status | |
| dc.subject | RFLP | |
| dc.subject | Molecular epidemiology | |
| dc.title | TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa | |
| dc.type | Journal Article |