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Community transmission of multidrug-resistant tuberculosis is associated with activity space overlap in Lima, Peru

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dc.contributor.author Bui, David P.
dc.contributor.author Chandran, Shruthi S.
dc.contributor.author Oren, Eyal
dc.contributor.author Brown, Heidi E.
dc.contributor.author Harris, Robin B.
dc.contributor.author Knight, Gwenan M.
dc.contributor.author Grandjean, Louis
dc.date.accessioned 2021-04-13T20:50:57Z
dc.date.available 2021-04-13T20:50:57Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9102
dc.description.abstract BACKGROUND: Transmission of multidrug-resistant tuberculosis (MDRTB) requires spatial proximity between infectious cases and susceptible persons. We assess activity space overlap among MDRTB cases and community controls to identify potential areas of transmission. METHODS: We enrolled 35 MDRTB cases and 64 TB-free community controls in Lima, Peru. Cases were whole genome sequenced and strain clustering was used as a proxy for transmission. GPS data were gathered from participants over seven days. Kernel density estimation methods were used to construct activity spaces from GPS locations and the utilization distribution overlap index (UDOI) was used to quantify activity space overlap. RESULTS: Activity spaces of controls (median = 35.6 km(2), IQR = 25.1-54) were larger than cases (median = 21.3 km(2), IQR = 17.9-48.6) (P = 0.02). Activity space overlap was greatest among genetically clustered cases (mean UDOI = 0.63, sd = 0.67) and lowest between cases and controls (mean UDOI = 0.13, sd = 0.28). UDOI was positively associated with genetic similarity of MDRTB strains between case pairs (P < 0.001). The odds of two cases being genetically clustered increased by 22% per 0.10 increase in UDOI (OR = 1.22, CI = 1.09-1.36, P < 0.001). CONCLUSIONS: Activity space overlap is associated with MDRTB clustering. MDRTB transmission may be occurring in small, overlapping activity spaces in community settings. GPS studies may be useful in identifying new areas of MDRTB transmission. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Activity space en_US
dc.subject Adult en_US
dc.subject Community transmission en_US
dc.subject Community-Acquired Infections/*epidemiology/*transmission en_US
dc.subject Female en_US
dc.subject Geographic Information Systems en_US
dc.subject GPS en_US
dc.subject Home range en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Social Networking en_US
dc.subject Tuberculosis en_US
dc.subject Tuberculosis, Multidrug-Resistant/*epidemiology/*transmission en_US
dc.subject Young Adult en_US
dc.title Community transmission of multidrug-resistant tuberculosis is associated with activity space overlap in Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12879-021-05953-8
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1471-2334


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