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Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes

Author

Listed:
  • Zhezhe Cui

    (Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
    Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
    These authors contributed equally to this work.)

  • Dingwen Lin

    (Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
    These authors contributed equally to this work.)

  • Virasakdi Chongsuvivatwong

    (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand)

  • Edward A. Graviss

    (Department of Pathology and Genomic Medicine, The Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX 77030, USA)

  • Angkana Chaiprasert

    (Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand)

  • Prasit Palittapongarnpim

    (Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10700, Thailand)

  • Mei Lin

    (Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China)

  • Jing Ou

    (Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China)

  • Jinming Zhao

    (Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China)

Abstract

The aims of the study were: (1) compare sociodemographic characteristics among active tuberculosis (TB) cases and their household contacts in cold and hot spot transmission areas, and (2) quantify the influence of locality, genotype and potential determinants on the rates of latent tuberculosis infection (LTBI) among household contacts of index TB cases. Parallel case-contact studies were conducted in two geographic areas classified as “cold” and “hot” spots based on TB notification and spatial clustering between January and June 2018 in Guangxi, China, using data from field contact investigations, whole genome sequencing, tuberculin skin tests (TSTs), and chest radiographs. Beijing family strains accounted for 64.6% of Mycobacterium tuberculosis (Mtb) strains transmitted in hot spots, and 50.7% in cold spots ( p -value = 0.02). The positive TST rate in hot spot areas was significantly higher than that observed in cold spot areas ( p -value < 0.01). Living in hot spots (adjusted odds ratio (aOR) = 1.75, 95%, confidence interval (CI): 1.22, 2.50), Beijing family genotype (aOR = 1.83, 95% CI: 1.19, 2.81), living in the same room with an index case (aOR = 2.29, 95% CI: 1.5, 3.49), travelling time from home to a medical facility (aOR = 4.78, 95% CI: 2.96, 7.72), history of Bacillus Calmette-Guérin vaccination (aOR = 2.02, 95% CI: 1.13 3.62), and delay in diagnosis (aOR = 2.56, 95% CI: 1.13, 5.80) were significantly associated with positive TST results among household contacts of TB cases. The findings of this study confirmed the strong transmissibility of the Beijing genotype family strains and this genotype’s important role in household transmission. We found that an extended traveling time from home to the medical facility was an important socioeconomic factor for Mtb transmission in the family. It is still necessary to improve the medical facility infrastructure and management, especially in areas with a high TB prevalence.

Suggested Citation

  • Zhezhe Cui & Dingwen Lin & Virasakdi Chongsuvivatwong & Edward A. Graviss & Angkana Chaiprasert & Prasit Palittapongarnpim & Mei Lin & Jing Ou & Jinming Zhao, 2019. "Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes," IJERPH, MDPI, vol. 16(10), pages 1-18, May.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:10:p:1863-:d:234575
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    References listed on IDEAS

    as
    1. Zhezhe Cui & Dingwen Lin & Virasakdi Chongsuvivatwong & Jinming Zhao & Mei Lin & Jing Ou & Jinghua Zhao, 2019. "Spatiotemporal patterns and ecological factors of tuberculosis notification: A spatial panel data analysis in Guangxi, China," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-15, May.
    2. Dongxiang Pan & Mei Lin & Rushu Lan & Edward A Graviss & Dingwen Lin & Dabin Liang & Xi Long & Huifang Qin & Liwen Huang & Minying Huang & Virasakdi Chongsuvivatwong, 2018. "Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China," IJERPH, MDPI, vol. 15(12), pages 1-10, December.
    3. M. C. Donohue & R. Overholser & R. Xu & F. Vaida, 2011. "Conditional Akaike information under generalized linear and proportional hazards mixed models," Biometrika, Biometrika Trust, vol. 98(3), pages 685-700.
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