A four-year nationwide molecular epidemiological study in Estonia: risk factors for tuberculosis transmission.
Public Health Action
; 4(Suppl 2): S34-40, 2014 Oct 21.
Article
in En
| MEDLINE
| ID: mdl-26393096
ABSTRACT
SETTING:
Estonia has a high proportion of multidrug-resistant tuberculosis (MDR-TB). It is important to link molecular and epidemiological data to understand TB transmission patterns.OBJECTIVE:
To use 24-locus variable numbers of tandem repeat (VNTR) typing and national TB registry data in Estonia from 2009 to 2012 to identify the distribution of drug resistance patterns, Mycobacterium tuberculosis isolate clustering as an index for recent transmission, socio-demographic and clinical characteristics associated with recent transmission, and the distribution of transmission between index and secondary cases.DESIGN:
A retrospective nationwide cross-sectional study.RESULTS:
Of 912 cases with isolate and patient information, 39.1% of isolates were from the Beijing lineage. Cluster analysis identified 87 clusters encompassing 69.1% of isolates. The largest cluster comprised 178 isolates from the Beijing lineage, of which 92.1% were MDR- or extensively drug-resistant TB (XDR-TB). Factors associated with recent transmission were polyresistant TB, MDR- and XDR-TB, human immunodeficiency virus positivity, Russian ethnicity, non-permanent living situation, alcohol abuse and detention. XDR-TB cases had the highest risk of recent transmission. The majority of transmission cases involved individuals aged 30-39 years.CONCLUSION:
Recent TB transmission in Estonia is high and is particularly associated with MDR- and XDR-TB and the Beijing lineage.
Full text:
1
Collection:
01-internacional
Health context:
3_ND
Database:
MEDLINE
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
Public Health Action
Year:
2014
Document type:
Article