Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study

BMC Infectious Diseases

Jonathan Mayer²  Charles Nolan²  Masahiro Narita¹  Eyal Oren² 

[1] Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA;Department of Epidemiology, University of Washington, Seattle, WA, USA

关键词: Molecular epidemiology;    Multilevel;    Infectious disease transmission;    Socioeconomic status;    Genotyping;    Tuberculosis;   

Others  :  1133974
DOI  :  10.1186/1471-2334-14-227

 received in 2013-10-22, accepted in 2014-04-16,  发布年份 2014

【 摘 要 】

Background

Current understanding of tuberculosis (TB) genotype clustering in the US is based on individual risk factors. This study sought to identify whether area-based socioeconomic status (SES) was associated with genotypic clustering among culture-confirmed TB cases.

Methods

A retrospective cohort analysis was performed on data collected on persons with incident TB in King County, Washington, 2004–2008. Multilevel models were used to identify the relationship between area-level SES at the block group level and clustering utilizing a socioeconomic position index (SEP).

Results

Of 519 patients with a known genotyping result and block group, 212 (41%) of isolates clustered genotypically. Analyses suggested an association between lower area-based SES and increased recent TB transmission, particularly among US-born populations. Models in which community characteristics were measured at the block group level demonstrated that lower area-based SEP was positively associated with genotypic clustering after controlling for individual covariates. However, the trend in higher clustering odds with lower SEP index quartile diminished when additional block-group covariates.

Conclusions

Results stress the need for TB control interventions that take area-based measures into account, with particular focus on poor neighborhoods. Interventions based on area-based characteristics, such as improving case finding strategies, utilizing location-based screening and addressing social inequalities, could reduce recent rates of transmission.

【 授权许可】

   
2014 Oren et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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