Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township

dc.contributor.authorMiddelkoop, Keren
dc.contributor.authorBekker, Linda-Gail
dc.contributor.authorMorrow, Carl
dc.contributor.authorZwane, Eugene
dc.contributor.authorWood, Robin
dc.date.accessioned2016-09-08T09:40:16Z
dc.date.available2016-09-08T09:40:16Z
dc.date.issued2009
dc.date.updated2016-01-07T08:16:30Z
dc.description.abstractBackground. Tuberculosis (TB) remains a leading cause of South African mortality and morbidity. While adult TB arises from both recent and prior infection, childhood TB results from recent infection and reflects ongoing transmission occurring despite current TB control strategies. Setting. A South African community with high rates of TB and HIV disease. Outcomes. A Geographic Information System was used to spatially and temporally define the relationships between TB exposure, infection and disease in children <15 years of age, with exposure to adult HIV-positive and HIV-negative TB disease on residential plots between 1997 and 2007. Results. During the study period the annual adult TB notification rate increased from 629 to 2106/100,000 and <15yrs TB notification rate ranged between 664/100,000 and 1044/100,000. The mean exposure to adult TB for uninfected children, TB-infected, TB cases was 5.1%, 5.4% and 33% per annum and the mean number of adult smear-positive cases per exposed child was 1.0, 1.6 and 1.9 respectively. Acquisition of TB infection was not associated with HIV status of adult exposure TB case and 36% of child TB cases were diagnosed prior to the temporally closest adult case on their plot. Conclusions. Childhood infection and disease were quantitatively linked to infectious adult TB prevalence in an immediate social network. Childhood infection should be monitored in high burden settings as a marker of ongoing TB transmission. Improved knowledge of township childhood and adult social networks may also facilitate targeted active case finding, which may provide an adjunct to presently failing TB control strategies.
dc.identifierhttp://dx.doi.org/10.7196/SAMJ.3376
dc.identifier.apacitationMiddelkoop, K., Bekker, L., Morrow, C., Zwane, E., & Wood, R. (2009). Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/21725en_ZA
dc.identifier.chicagocitationMiddelkoop, Keren, Linda-Gail Bekker, Carl Morrow, Eugene Zwane, and Robin Wood "Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/21725en_ZA
dc.identifier.citationMiddelkoop, K., Bekker, L., Morrow, C., Zwane, E., & Wood, R. (2009). Childhood tuberculosis infection and disease: a spatial and temporal transmission analysis in a South African township. South African Medical Journal, 99(10), 738.
dc.identifier.ris TY - Journal Article AU - Middelkoop, Keren AU - Bekker, Linda-Gail AU - Morrow, Carl AU - Zwane, Eugene AU - Wood, Robin AB - Background. Tuberculosis (TB) remains a leading cause of South African mortality and morbidity. While adult TB arises from both recent and prior infection, childhood TB results from recent infection and reflects ongoing transmission occurring despite current TB control strategies. Setting. A South African community with high rates of TB and HIV disease. Outcomes. A Geographic Information System was used to spatially and temporally define the relationships between TB exposure, infection and disease in children <15 years of age, with exposure to adult HIV-positive and HIV-negative TB disease on residential plots between 1997 and 2007. Results. During the study period the annual adult TB notification rate increased from 629 to 2106/100,000 and <15yrs TB notification rate ranged between 664/100,000 and 1044/100,000. The mean exposure to adult TB for uninfected children, TB-infected, TB cases was 5.1%, 5.4% and 33% per annum and the mean number of adult smear-positive cases per exposed child was 1.0, 1.6 and 1.9 respectively. Acquisition of TB infection was not associated with HIV status of adult exposure TB case and 36% of child TB cases were diagnosed prior to the temporally closest adult case on their plot. Conclusions. Childhood infection and disease were quantitatively linked to infectious adult TB prevalence in an immediate social network. Childhood infection should be monitored in high burden settings as a marker of ongoing TB transmission. Improved knowledge of township childhood and adult social networks may also facilitate targeted active case finding, which may provide an adjunct to presently failing TB control strategies. DA - 2009 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township TI - Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township UR - http://hdl.handle.net/11427/21725 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21725
dc.identifier.vancouvercitationMiddelkoop K, Bekker L, Morrow C, Zwane E, Wood R. Childhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township. South African Medical Journal. 2009; http://hdl.handle.net/11427/21725.en_ZA
dc.language.isoeng
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleChildhood tuberculosis infection and disease: A spatial and temporal transmission analysis in a South African township
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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