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Drivers of Tuberculosis Transmission
Barun Mathema1, Jason R Andrews2, Ted Cohen3
1Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
The Journal of Infectious Diseases
|November 8, 2017
Summary
Estimating tuberculosis transmission is challenging due to variable disease timing. New genomic tools enhance our understanding of Mycobacterium tuberculosis spread and transmission chains in communities.
Area of Science:
- Epidemiology
- Microbiology
- Public Health
Background:
- Tuberculosis (TB) disease timing after Mycobacterium tuberculosis infection varies significantly, complicating transmission measurement.
- Distinguishing recent from remote infections is crucial for understanding TB epidemiology.
- Population-level and individual-level transmission estimation methods are needed.
Purpose of the Study:
- To provide an overview of factors influencing tuberculosis transmission.
- To describe current tools for measuring tuberculosis transmission.
- To identify knowledge gaps in understanding tuberculosis transmission dynamics.
Main Methods:
- Review of epidemiological data, including tuberculosis case notifications in children.
- Analysis of trends in tuberculin skin test (TST) and interferon-gamma release assays (IGRAs).
- Application of Mycobacterium tuberculosis whole-genome sequencing for transmission chain analysis.
Main Results:
- Tuberculosis case notifications in young children and immunological assays provide insights into recent transmission.
- Whole-genome sequencing allows estimation of population transmission levels and strain distribution.
- Community factors like prevalence, social interactions, and healthcare capacity significantly impact transmission.
Conclusions:
- Measuring tuberculosis transmission remains complex but is advancing with new tools.
- Genomic epidemiology offers powerful insights into transmission chains and population dynamics.
- Addressing knowledge gaps is essential for effective tuberculosis control strategies.
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