American journal of public health · 2006
Transmission network analysis to complement routine tuberculosis contact investigations.
СтатьяПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Andre McKenzie, Ijaz Kashef, Tillinghast Jon D, Krebs Valdis E, Diem Lois A, Metchock Beverly, Crisp Theresa, McElroy Peter D
Аннотация
OBJECTIVE: We examined the feasibility and value of network analysis to complement routine tuberculosis (TB) contact investigation procedures during an outbreak.
METHODS: We reviewed hospital, health department, and jail records and interviewed TB patients. Mycobacterium tuberculosis isolates were genotyped. We evaluated contacts of TB patients for latent TB infection (LTBI) and TB, and analyzed routine contact investigation data, including tuberculin skin test (TST) results. Outcomes included number of contacts identified, number of contacts evaluated, and their TST status. We used network analysis visualizations and metrics (reach, degree, betweenness) to characterize the outbreak.
RESULTS: secondary TB patients and more than 1200 contacts. Genotyping detected a 21-band pattern of a strain W variant. No HIV-infected patients were diagnosed. Contacts prioritized by network analysis were more likely to have LTBI than nonprioritized contacts (odds ratio=7.8; 95% confidence interval=1.6, 36.6). Network visualizations and metrics highlighted patients central to sustaining the outbreak and helped prioritize contacts for evaluation.
CONCLUSIONS: A network-informed approach to TB contact investigations provided a novel means to examine large quantities of data and helped focus TB control.
METHODS: We reviewed hospital, health department, and jail records and interviewed TB patients. Mycobacterium tuberculosis isolates were genotyped. We evaluated contacts of TB patients for latent TB infection (LTBI) and TB, and analyzed routine contact investigation data, including tuberculin skin test (TST) results. Outcomes included number of contacts identified, number of contacts evaluated, and their TST status. We used network analysis visualizations and metrics (reach, degree, betweenness) to characterize the outbreak.
RESULTS: secondary TB patients and more than 1200 contacts. Genotyping detected a 21-band pattern of a strain W variant. No HIV-infected patients were diagnosed. Contacts prioritized by network analysis were more likely to have LTBI than nonprioritized contacts (odds ratio=7.8; 95% confidence interval=1.6, 36.6). Network visualizations and metrics highlighted patients central to sustaining the outbreak and helped prioritize contacts for evaluation.
CONCLUSIONS: A network-informed approach to TB contact investigations provided a novel means to examine large quantities of data and helped focus TB control.
Предметные рубрики MeSH
AdolescentAdultCenters for Disease Control and Prevention, U.S.ChildChild, PreschoolCluster AnalysisContact TracingDisease OutbreaksFeasibility StudiesFemaleGenotypeHumansInfantMaleMycobacterium tuberculosisOklahomaPublic Health AdministrationPublic Health InformaticsSocial SupportTuberculosisUnited States