UA Open Access Publishing Fund / 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.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/617199 |
| Date | 27 April 2014 |
| Creators | Oren, Eyal, Narita, Masahiro, Nolan, Charles, Mayer, Jonathan |
| Contributors | Division of Epidemiology & Biostatistics, University of Arizona |
| Publisher | BMC |
| Source Sets | University of Arizona |
| Language | English |
| Detected Language | English |
| Type | Article |
| Rights | © 2014 Oren et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0). |
| Relation | http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-227 |
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