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Recent Tuberculosis Transmission and Clustering: An Evaluation of Clinical and Molecular Epidemiological Risk Factors in Ohio, 2006-2015

Alamoudi, Banan Mohammad A
http://orcid.org/0000-0003-1351-7271
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1510916185962819

Abstract Details

2017, MPH, University of Cincinnati, Medicine: Epidemiology.
Background: Twenty-seven states reported an increase in the number of tuberculosis (TB) cases from 2014 to 2015 in the United States. Identification of risk groups for recent transmission is critical to effective TB control measures. Mycobacterium tuberculosis (MTB) genotyping can identify chains of TB transmission. We investigated clinical and molecular epidemiological characteristics to estimate the proportion of cases due to recent TB transmission and identify predictors of clustered cases. We aimed to determine the association of living in urban areas and genotypically clustered MTB isolates in TB patients in Ohio. Methods: We analyzed the Center for Disease Control’s TB Genotyping Information Management System (TB GIMS) data for all confirmed adult patients (age ≥15 years) with TB, who had spoliogtype and 12-locus mycobacterial interspersed repetitive unit-variable number of tandem repeat typing data available, from 2006-2015 in Ohio. Univariable and multivariable logistic regression was used to examine sociodemographic and clinical risk factors for clustering of TB cases stratified by HIV status. Results: Of the 1,471 cases occurring, 1,210 (82%) were genotyped; 928 (79%) had pulmonary TB and 437 (37%) were clustered in 38 clusters that ranged from 2 to 38 cases. Annual prevalence of clustering ranged from 31%-41%. Clustered cases were more likely to live in urban settings, be U.S.-born, be HIV-infected, be homeless, have pulmonary TB, and have history of drug and alcohol use, and time in correctional facilities. In adjusted analyses, the odds of clustering were decreased among cases who were foreign-born (aOR 0.3, 95% CI: 0.2-0.4) compared to U.S.-born. In analyses stratified by HIV status, living in urban areas was not associated with clustered TB cases (Ρ>0.05). Conclusion: Approximately one-third of the TB cases in Ohio are clustered due to recent transmission. TB control resources should prioritize identification and targeting of high-risk groups for clustered TB cases to help prevent transmission of TB.
Liza Murrison, Ph.D MPH (Committee Chair)
Lisa Haglund, M.D. (Committee Member)
68 p.
Public Health
Tuberculosis; Molecular Genotyping; TB GIMS; Ohio; Epidemiology

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Citations

  • Alamoudi, B. M. A. (2017). Recent Tuberculosis Transmission and Clustering: An Evaluation of Clinical and Molecular Epidemiological Risk Factors in Ohio, 2006-2015 [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1510916185962819

    APA Style (7th edition)

  • Alamoudi, Banan. Recent Tuberculosis Transmission and Clustering: An Evaluation of Clinical and Molecular Epidemiological Risk Factors in Ohio, 2006-2015. 2017. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1510916185962819.

    MLA Style (8th edition)

  • Alamoudi, Banan. "Recent Tuberculosis Transmission and Clustering: An Evaluation of Clinical and Molecular Epidemiological Risk Factors in Ohio, 2006-2015." Master's thesis, University of Cincinnati, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1510916185962819

    Chicago Manual of Style (17th edition)

ucin1510916185962819
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This open access ETD is published by University of Cincinnati and OhioLINK.