Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination
BACKGROUND: A context-specific, spatial-temporal understanding of a chain of tuberculosis (TB) transmission can inform TB elimination strategy. METHODS: Clinical, public health and molecular epidemiologic data were used to: 1) identify and describe a complex cluster of TB cases in Alberta, 2) elucid...
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ftpubmed:oai:pubmedcentral.nih.gov:6973929 2023-05-15T17:46:45+02:00 Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination Aspler, Anne Chong, Huey Kunimoto, Dennis Chui, Linda Der, Evelina Boffa, Jody Long, Richard 2010-05-01 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973929/ http://www.ncbi.nlm.nih.gov/pubmed/20737810 https://doi.org/10.1007/BF03404391 en eng Springer International Publishing http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973929/ http://www.ncbi.nlm.nih.gov/pubmed/20737810 http://dx.doi.org/10.1007/BF03404391 © The Canadian Public Health Association 2010 Quantitative Research Text 2010 ftpubmed https://doi.org/10.1007/BF03404391 2020-02-09T01:20:25Z BACKGROUND: A context-specific, spatial-temporal understanding of a chain of tuberculosis (TB) transmission can inform TB elimination strategy. METHODS: Clinical, public health and molecular epidemiologic data were used to: 1) identify and describe a complex cluster of TB cases in Alberta, 2) elucidate transmission sequences, and 3) assess case-patient mobility. Socio-economic indicators in loci of transmission and the province at large were described. Factors seen to be fostering or hampering TB elimination were identified. RESULTS: Over a 15-year period, 18 TB cases in Alberta and multiple cases in the Northwest Territories were determined to be due to the same strain. One patient was diagnosed at death; all others completed directly-observed therapy (DOT). Case-level analysis revealed that patients were highly mobile with transmission of the strain over 26,569 km(2), an average of 2.8 different places of residence per patient during treatment, and contacts of sputum smear-positive cases spanning 9 of 17 regional health authorities. The majority of the contacts (57%) were attached to a single infectious case living in a homeless shelter. The three loci of transmission in Alberta were separated geographically but similar in terms of median incomes, rates of unemployment, levels of post-secondary education, and rates of population mobility (p<0.0001). CONCLUSION: Upon review of the experience, central oversight, intra- and inter-jurisdictional coordination and DOT were seen as fostering, and the absence of ‘real-time’ DNA fingerprinting, social network analysis, engineering controls in shelters and better determinants of health in loci of transmission were seen as hampering TB elimination. Text Northwest Territories PubMed Central (PMC) Northwest Territories Canadian Journal of Public Health 101 3 205 209 |
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Quantitative Research |
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Quantitative Research Aspler, Anne Chong, Huey Kunimoto, Dennis Chui, Linda Der, Evelina Boffa, Jody Long, Richard Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
topic_facet |
Quantitative Research |
description |
BACKGROUND: A context-specific, spatial-temporal understanding of a chain of tuberculosis (TB) transmission can inform TB elimination strategy. METHODS: Clinical, public health and molecular epidemiologic data were used to: 1) identify and describe a complex cluster of TB cases in Alberta, 2) elucidate transmission sequences, and 3) assess case-patient mobility. Socio-economic indicators in loci of transmission and the province at large were described. Factors seen to be fostering or hampering TB elimination were identified. RESULTS: Over a 15-year period, 18 TB cases in Alberta and multiple cases in the Northwest Territories were determined to be due to the same strain. One patient was diagnosed at death; all others completed directly-observed therapy (DOT). Case-level analysis revealed that patients were highly mobile with transmission of the strain over 26,569 km(2), an average of 2.8 different places of residence per patient during treatment, and contacts of sputum smear-positive cases spanning 9 of 17 regional health authorities. The majority of the contacts (57%) were attached to a single infectious case living in a homeless shelter. The three loci of transmission in Alberta were separated geographically but similar in terms of median incomes, rates of unemployment, levels of post-secondary education, and rates of population mobility (p<0.0001). CONCLUSION: Upon review of the experience, central oversight, intra- and inter-jurisdictional coordination and DOT were seen as fostering, and the absence of ‘real-time’ DNA fingerprinting, social network analysis, engineering controls in shelters and better determinants of health in loci of transmission were seen as hampering TB elimination. |
format |
Text |
author |
Aspler, Anne Chong, Huey Kunimoto, Dennis Chui, Linda Der, Evelina Boffa, Jody Long, Richard |
author_facet |
Aspler, Anne Chong, Huey Kunimoto, Dennis Chui, Linda Der, Evelina Boffa, Jody Long, Richard |
author_sort |
Aspler, Anne |
title |
Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
title_short |
Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
title_full |
Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
title_fullStr |
Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
title_full_unstemmed |
Sustained Intra- and Inter-jurisdictional Transmission of Tuberculosis within a Mobile, Multi-ethnic Social Network: Lessons for Tuberculosis Elimination |
title_sort |
sustained intra- and inter-jurisdictional transmission of tuberculosis within a mobile, multi-ethnic social network: lessons for tuberculosis elimination |
publisher |
Springer International Publishing |
publishDate |
2010 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973929/ http://www.ncbi.nlm.nih.gov/pubmed/20737810 https://doi.org/10.1007/BF03404391 |
geographic |
Northwest Territories |
geographic_facet |
Northwest Territories |
genre |
Northwest Territories |
genre_facet |
Northwest Territories |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973929/ http://www.ncbi.nlm.nih.gov/pubmed/20737810 http://dx.doi.org/10.1007/BF03404391 |
op_rights |
© The Canadian Public Health Association 2010 |
op_doi |
https://doi.org/10.1007/BF03404391 |
container_title |
Canadian Journal of Public Health |
container_volume |
101 |
container_issue |
3 |
container_start_page |
205 |
op_container_end_page |
209 |
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1766150567673987072 |