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Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal

SETTING: Molecular epidemiology suggests that most Mycobacterium tuberculosis transmission in high-burden settings occurs outside the home. OBJECTIVE: To estimate the risk of M. tuberculosis transmission inside public buildings in a high TB burden community in KwaZulu-Natal, South Africa. DESIGN: Ca...

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Autores principales: Taylor, J. G., Yates, T. A., Mthethwa, M., Tanser, F., Abubakar, I., Altamirano, H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Union Against Tuberculosis and Lung Disease 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978153/
https://www.ncbi.nlm.nih.gov/pubmed/27510239
http://dx.doi.org/10.5588/ijtld.16.0085
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author Taylor, J. G.
Yates, T. A.
Mthethwa, M.
Tanser, F.
Abubakar, I.
Altamirano, H.
author_facet Taylor, J. G.
Yates, T. A.
Mthethwa, M.
Tanser, F.
Abubakar, I.
Altamirano, H.
author_sort Taylor, J. G.
collection PubMed
description SETTING: Molecular epidemiology suggests that most Mycobacterium tuberculosis transmission in high-burden settings occurs outside the home. OBJECTIVE: To estimate the risk of M. tuberculosis transmission inside public buildings in a high TB burden community in KwaZulu-Natal, South Africa. DESIGN: Carbon dioxide (CO(2)) sensors were placed inside eight public buildings. Measurements were used with observations of occupancy to estimate infection risk using an adaptation of the Wells-Riley equation. Ventilation modelling using CONTAM was used to examine the impact of low-cost retrofits on transmission in a health clinic. RESULTS: Measurements indicate that infection risk in the church, classroom and clinic waiting room would be high with typical ventilation, occupancy levels and visit durations. For example, we estimated that health care workers in a clinic waiting room had a 16.9–24.5% annual risk of M. tuberculosis infection. Modelling results indicate that the simple addition of two new windows allowing for cross-ventilation, at a cost of US$330, would reduce the annual risk to health care workers by 57%. CONCLUSIONS: Results indicate that public buildings in this community have a range of ventilation and occupancy characteristics that may influence transmission risks. Simple retrofits may result in dramatic reductions in M. tuberculosis transmission, and intervention studies should therefore be considered.
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spelling pubmed-49781532016-09-01 Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal Taylor, J. G. Yates, T. A. Mthethwa, M. Tanser, F. Abubakar, I. Altamirano, H. Int J Tuberc Lung Dis Original Articles SETTING: Molecular epidemiology suggests that most Mycobacterium tuberculosis transmission in high-burden settings occurs outside the home. OBJECTIVE: To estimate the risk of M. tuberculosis transmission inside public buildings in a high TB burden community in KwaZulu-Natal, South Africa. DESIGN: Carbon dioxide (CO(2)) sensors were placed inside eight public buildings. Measurements were used with observations of occupancy to estimate infection risk using an adaptation of the Wells-Riley equation. Ventilation modelling using CONTAM was used to examine the impact of low-cost retrofits on transmission in a health clinic. RESULTS: Measurements indicate that infection risk in the church, classroom and clinic waiting room would be high with typical ventilation, occupancy levels and visit durations. For example, we estimated that health care workers in a clinic waiting room had a 16.9–24.5% annual risk of M. tuberculosis infection. Modelling results indicate that the simple addition of two new windows allowing for cross-ventilation, at a cost of US$330, would reduce the annual risk to health care workers by 57%. CONCLUSIONS: Results indicate that public buildings in this community have a range of ventilation and occupancy characteristics that may influence transmission risks. Simple retrofits may result in dramatic reductions in M. tuberculosis transmission, and intervention studies should therefore be considered. International Union Against Tuberculosis and Lung Disease 2016-09 2016-07-08 /pmc/articles/PMC4978153/ /pubmed/27510239 http://dx.doi.org/10.5588/ijtld.16.0085 Text en © 2016 Taylor et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Articles
Taylor, J. G.
Yates, T. A.
Mthethwa, M.
Tanser, F.
Abubakar, I.
Altamirano, H.
Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title_full Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title_fullStr Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title_full_unstemmed Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title_short Measuring ventilation and modelling M. tuberculosis transmission in indoor congregate settings, rural KwaZulu-Natal
title_sort measuring ventilation and modelling m. tuberculosis transmission in indoor congregate settings, rural kwazulu-natal
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978153/
https://www.ncbi.nlm.nih.gov/pubmed/27510239
http://dx.doi.org/10.5588/ijtld.16.0085
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