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High Tuberculosis Strain Diversity Among New York City Public Housing Residents

Affiliation

  • 1 All authors are with the New York City Department of Health and Mental Hygiene Bureau of Tuberculosis Control, Queens, NY. Patrick Dawson is also with Columbia University Mailman School of Public Health Department of Epidemiology, New York, NY.
  • PMID: 26691125
  • PMCID: PMC4815708
  • DOI: 10.2105/AJPH.2015.302910

Free PMC article

High Tuberculosis Strain Diversity Among New York City Public Housing Residents

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Authors

Affiliation

  • 1 All authors are with the New York City Department of Health and Mental Hygiene Bureau of Tuberculosis Control, Queens, NY. Patrick Dawson is also with Columbia University Mailman School of Public Health Department of Epidemiology, New York, NY.
  • PMID: 26691125
  • PMCID: PMC4815708
  • DOI: 10.2105/AJPH.2015.302910

Abstract

Objectives: We sought to better understand tuberculosis (TB) epidemiology among New York City Housing Authority (NYCHA) residents, after a recent TB investigation identified patients who had the same TB strain.

Methods: The study population included all New York City patients with TB confirmed during 2001 through 2009. Patient address at diagnosis determined NYCHA residence. We calculated TB incidence, reviewed TB strain data, and identified factors associated with TB clustering.

Results: During 2001 to 2009, of 8953 individuals in New York City with TB, 512 (6%) had a NYCHA address. Among the US-born, TB incidence among NYCHA residents (6.0/100,000 persons) was twice that among non-NYCHA residents (3.0/100,000 persons). Patients in NYCHA had high TB strain diversity. US birth, younger age, and substance use were associated with TB clustering among NYCHA individuals with TB.

Conclusions: High TB strain diversity among residents of NYCHA with TB does not suggest transmission among residents. These findings illustrate that NYCHA’s higher TB incidence is likely attributable to its higher concentration of individuals with known TB risk factors.

High TB strain diversity among residents of NYCHA with TB does not suggest transmission among residents. These findings illustrate that NYCHA's higher TB incidence is likely attributable to its higher concentration of individuals with known TB risk factors.

Factors affecting tuberculosis strain success over 10 years in a high TB- and HIV-burdened community

Affiliations

  • 1 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USADesmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA [email protected]
  • 2 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USADesmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA.
  • 3 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA.
  • PMID: 24609068
  • PMCID: PMC4121554
  • DOI: 10.1093/ije/dyu044

Free PMC article

Factors affecting tuberculosis strain success over 10 years in a high TB- and HIV-burdened community

  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

Authors

Affiliations

  • 1 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USADesmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA [email protected]
  • 2 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USADesmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA.
  • 3 Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa, Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, New York, USA, Public Health Research Institute, Tuberculosis Center, New Jersey Medical School, Rutgers, State University of New Jersey, Newark, USA, Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa, National Health Laboratory Service, Cape Town, South Africa, Division of Medical Microbiology, Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa and Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, USA.
  • PMID: 24609068
  • PMCID: PMC4121554
  • DOI: 10.1093/ije/dyu044

Abstract

Background: Factors associated with Mycobacterium tuberculosis (Mtb) strain success over time in high burdened communities are unknown.

Methods: Mtb isolates collected over 10 years from sputum-positive tuberculosis (TB) patients resident in the study site underwent IS6110-based restriction fragment length polymorphism analysis. Clinical, demographic and social data were extracted from clinic records and interviewer-administered questionnaires. Strains were defined as persistently successful, transiently successful or unsuccessful based on the average number of cases per year and their continued presence over time.

Results: Genotyping data were available on 789 TB cases. Of the 311 distinct Mtb strains (≥6 bands) identified, 247 were categorized as unsuccessful strains, 12 transiently successful and 10 persistently successful strains. Strain success was not associated with age, gender, antiretroviral use or social factors. Persistently successful strains were less likely to be drug-resistant compared with transiently successful strains [odds ratio (OR): 0.13; 95% confidence interval (CI): 0.04 – 0.5]. Persistently successful strains were positively associated with host HIV-infection compared with unsuccessful strains, but this finding was not robust in sensitivity analyses.

Conclusions: Pathogen characteristics appear to play a greater role in Mtb strain success compared with social or host factors. This study supports the need for further investigations into the role of pathogen characteristics in strain success.

Keywords: Tuberculosis; epidemiology; molecular; polymorphism; pulmonary; restriction fragment length.

© The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Pathogen characteristics appear to play a greater role in Mtb strain success compared with social or host factors. This study supports the need for further investigations into the role of pathogen characteristics in strain success.