Partitioning the risk of tuberculosis transmission in household contact studies

Autoři: Avery I. McIntosh aff001;  Helen E. Jenkins aff001;  C. Robert Horsburgh aff001;  Edward C. Jones-López aff003;  Christopher C. Whalen aff004;  Mary Gaeddert aff003;  Patricia Marques-Rodrigues aff005;  Jerrold J. Ellner aff003;  Reynaldo Dietze aff005;  Laura F. White aff001
Působiště autorů: Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America aff001;  Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America aff002;  Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts, United States of America aff003;  Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, United States of America aff004;  Núcleo de Doenças Infecciosas, Vitória, Brazil aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article


Household contact studies of tuberculosis (TB) are a common way to study disease transmission dynamics. However these studies lack a mechanism for accounting for community transmission, which is known to be significant, particularly in high burden settings. We illustrate a statistical approach for estimating both the correlates with transmission of TB in a household setting and the probability of community transmission using a modified Bayesian mixed-effects model. This is applied to two household contact studies in Vitória, Brazil from 2008–2013 and Kampala, Uganda from 1995–2004 that enrolled households with an individual that was recently diagnosed with pulmonary TB. We estimate the probability of community transmission to be higher in Uganda (ranging from 0.21 to 0.69, depending on HHC age and HIV status of the index case) than in Brazil (ranging from 0.13 for young children to 0.50 in adults). These estimates are consistent with a higher overall burden of disease in Uganda compared to Brazil. Our method also estimates an increasing risk of community-acquired TB with age of the household contact, consistent with existing literature. This approach is a useful way to integrate the role of the community in understanding TB disease transmission dynamics in household contact studies.

Klíčová slova:

Age groups – Brazil – Medical risk factors – Tuberculosis – Tuberculosis diagnosis and management – Uganda – Restriction fragment length polymorphism analysis


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2019 Číslo 10
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