Extensively drug-resistant tuberculosis hotspots and sociodemographic associations in Durban, South Africa
dc.contributor.author | Peterson, Meaghan L. | |
dc.contributor.author | Gandhi, Neel R. | |
dc.contributor.author | Clennon, Julie | |
dc.contributor.author | Nelson, Kristin N. | |
dc.contributor.author | Morris, Natashia | |
dc.contributor.author | Ismail, Nazir Ahmed | |
dc.contributor.author | Allana, Salim | |
dc.contributor.author | Campbell, Angie | |
dc.contributor.author | Brust, James C.M. | |
dc.contributor.author | Auld, Sara C. | |
dc.contributor.author | Mathema, Barun | |
dc.contributor.author | Mlisana, Koleka | |
dc.contributor.author | Moodley, Pravi | |
dc.contributor.author | Shah, N. Sarita | |
dc.date.accessioned | 2020-03-10T08:07:35Z | |
dc.date.available | 2020-03-10T08:07:35Z | |
dc.date.issued | 2019-06 | |
dc.description.abstract | BACKGROUND : Extensively drug-resistant tuberculosis (XDR-TB) incidence is driven by transmission of resistant strains in KwaZulu-Natal, South Africa. Data suggests cases may be spatially clustered; we therefore sought to identify hotspots and describe these communities. METHODS : We enrolled XDR-TB patients diagnosed from 2011–2014 in eThekwini. GPS coordinates for participant homes were collected and hotspots were identified based on population-adjusted XDR-TB incidence. Sociodemographic features of hotspots were characterized using census data. For a subset of participants, we mapped XDR-TB case non-home congregate locations and compared to results including only homes. RESULTS : Among 132 participants, 75 (57%) were female and 87 (66%) lived in urban or suburban locations. Fifteen of 197 census tracts were identified as XDR-TB hotspots with ≥ 95% confidence. Four spatial mapping methods identified one large hotspot in northeastern eThekwini. Hotspot communities had higher percentages of low educational attainment (12% vs 9%), higher unemployment (29.3% vs 20.4%), and lower percentage of homes with flush toilets (36.4% vs 68.9%). Mapping congregate locations, including workplaces, for 43 (33%) participants shifted case density towards Durban. CONCLUSIONS : In eThekwini, XDR-TB case homes were clustered into hotspots with more indicators of poverty than non-hotspots. Prevention efforts targeting hotspot communities and congregate settings may be effective in reducing community transmission. | en_ZA |
dc.description.department | Medical Microbiology | en_ZA |
dc.description.librarian | hj2020 | en_ZA |
dc.description.sponsorship | A grant from the US National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH): R01AI089349 (PI Gandhi) and R01AI087465 (PI Gandhi). It was also supported in part by NIH/NIAID grants: K23AI083088 (PI Brust), K23AI134182 (PI Auld), K24AI114444 (PI Gandhi), R01AI138646 (PI Gandhi), Emory CFAR P30AI050409 (PI Curran), Einstein CFAR P30AI124414 (PI Goldstein), by Einstein/Montefiore ICTR UL1 TR001073 (PI Shamoon), and by NIH/NHLBI T32 HL116271 (PI Guidot). | en_ZA |
dc.description.uri | https://www.ingentaconnect.com/content/iuatld/ijtld | en_ZA |
dc.identifier.citation | Peterson, M.L., Gandhi, N.R., Clennon, J. et al. 2019, 'Extensively drug-resistant tuberculosis hotspots and sociodemographic associations in Durban, South Africa', International Journal of Tuberculosis and Lung Disease. vol. 23, no. 6, pp. 720–727. doi: 10.5588/ijtld.18.0575. | en_ZA |
dc.identifier.issn | 1027-3719 (print) | |
dc.identifier.issn | 1815-7920 (online) | |
dc.identifier.other | 10.5588/ijtld.18.0575 | |
dc.identifier.uri | http://hdl.handle.net/2263/73697 | |
dc.language.iso | en | en_ZA |
dc.publisher | International Union Against Tuberculosis and Lung Disease | en_ZA |
dc.rights | International Union Against Tuberculosis and Lung Disease | en_ZA |
dc.subject | Tuberculosis (TB) | en_ZA |
dc.subject | Extensively drug-resistant tuberculosis (XDR-TB) | en_ZA |
dc.subject | Activity space | en_ZA |
dc.subject | Sociodemographic | en_ZA |
dc.subject | Hotspot | en_ZA |
dc.subject | South Africa (SA) | en_ZA |
dc.title | Extensively drug-resistant tuberculosis hotspots and sociodemographic associations in Durban, South Africa | en_ZA |
dc.type | Postprint Article | en_ZA |