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Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study

BACKGROUND: Current understanding of tuberculosis (TB) genotype clustering in the US is based on individual risk factors. This study sought to identify whether area-based socioeconomic status (SES) was associated with genotypic clustering among culture-confirmed TB cases. METHODS: A retrospective co...

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Autores principales: Oren, Eyal, Narita, Masahiro, Nolan, Charles, Mayer, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013806/
https://www.ncbi.nlm.nih.gov/pubmed/24767197
http://dx.doi.org/10.1186/1471-2334-14-227
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author Oren, Eyal
Narita, Masahiro
Nolan, Charles
Mayer, Jonathan
author_facet Oren, Eyal
Narita, Masahiro
Nolan, Charles
Mayer, Jonathan
author_sort Oren, Eyal
collection PubMed
description BACKGROUND: Current understanding of tuberculosis (TB) genotype clustering in the US is based on individual risk factors. This study sought to identify whether area-based socioeconomic status (SES) was associated with genotypic clustering among culture-confirmed TB cases. METHODS: A retrospective cohort analysis was performed on data collected on persons with incident TB in King County, Washington, 2004–2008. Multilevel models were used to identify the relationship between area-level SES at the block group level and clustering utilizing a socioeconomic position index (SEP). RESULTS: Of 519 patients with a known genotyping result and block group, 212 (41%) of isolates clustered genotypically. Analyses suggested an association between lower area-based SES and increased recent TB transmission, particularly among US-born populations. Models in which community characteristics were measured at the block group level demonstrated that lower area-based SEP was positively associated with genotypic clustering after controlling for individual covariates. However, the trend in higher clustering odds with lower SEP index quartile diminished when additional block-group covariates. CONCLUSIONS: Results stress the need for TB control interventions that take area-based measures into account, with particular focus on poor neighborhoods. Interventions based on area-based characteristics, such as improving case finding strategies, utilizing location-based screening and addressing social inequalities, could reduce recent rates of transmission.
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spelling pubmed-40138062014-05-09 Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study Oren, Eyal Narita, Masahiro Nolan, Charles Mayer, Jonathan BMC Infect Dis Research Article BACKGROUND: Current understanding of tuberculosis (TB) genotype clustering in the US is based on individual risk factors. This study sought to identify whether area-based socioeconomic status (SES) was associated with genotypic clustering among culture-confirmed TB cases. METHODS: A retrospective cohort analysis was performed on data collected on persons with incident TB in King County, Washington, 2004–2008. Multilevel models were used to identify the relationship between area-level SES at the block group level and clustering utilizing a socioeconomic position index (SEP). RESULTS: Of 519 patients with a known genotyping result and block group, 212 (41%) of isolates clustered genotypically. Analyses suggested an association between lower area-based SES and increased recent TB transmission, particularly among US-born populations. Models in which community characteristics were measured at the block group level demonstrated that lower area-based SEP was positively associated with genotypic clustering after controlling for individual covariates. However, the trend in higher clustering odds with lower SEP index quartile diminished when additional block-group covariates. CONCLUSIONS: Results stress the need for TB control interventions that take area-based measures into account, with particular focus on poor neighborhoods. Interventions based on area-based characteristics, such as improving case finding strategies, utilizing location-based screening and addressing social inequalities, could reduce recent rates of transmission. BioMed Central 2014-04-27 /pmc/articles/PMC4013806/ /pubmed/24767197 http://dx.doi.org/10.1186/1471-2334-14-227 Text en Copyright © 2014 Oren et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Oren, Eyal
Narita, Masahiro
Nolan, Charles
Mayer, Jonathan
Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title_full Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title_fullStr Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title_full_unstemmed Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title_short Neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
title_sort neighborhood socioeconomic position and tuberculosis transmission: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013806/
https://www.ncbi.nlm.nih.gov/pubmed/24767197
http://dx.doi.org/10.1186/1471-2334-14-227
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