Determinants of cluster size in large, population-based molecular epidemiology study of tuberculosis, northern Malawi

Glynn, J. R., Crampin, A. C. , Traore, H., Chaguluka, S., Mwafulirwa, D. T., Alghamdi, S., Ngwira, B. M.M., Yates, M. D., Drobniewski, F. D. and Fine, P. E.M. (2008) Determinants of cluster size in large, population-based molecular epidemiology study of tuberculosis, northern Malawi. Emerging Infectious Diseases, 14(7), pp. 1060-1066. (doi: 10.3201/eid1407.060468) (PMID:18598626) (PMCID:PMC2600342)

Abstract

Tuberculosis patients with identical strains of Mycobacterium tuberculosis are described as clustered. Cluster size may depend on patient or strain characteristics. In a 7-year population-based study of tuberculosis in Karonga District, Malawi, clusters were defined by using IS6110 restriction fragment length polymorphism, excluding patterns with <5 bands. Spoligotyping was used to compare strains with an international database. Among 682 clustered patients, cluster size ranged from 2 to 37. Male patients, young adults, and town residents were over-represented in large clusters. Cluster size was not associated with HIV status or death from tuberculosis. Spoligotypes from 9 (90%) of 10 large cluster strains were identical or very similar (1 spacer different) to common spoligotypes found elsewhere, compared with 37 (66%) of 56 of those from nonclustered patients (p = 0.3). Large clusters were associated with factors likely to be related to social mixing, but spoligotypes of common strains in this setting were also common types elsewhere, consistent with strain differences in transmissibility.

• Item Type: Articles
• Additional Information: Until 1996 the Karonga Prevention Study was funded primarily by the British Leprosy Relief Association and the International Federation of Anti-Leprosy Organizations, with contributions from the World Health Organization/United Nations Development Program/World Bank Special Programme for Research and Training in Tropical Diseases. Since 1996, the Wellcome Trust has been the principal funder. J.R.G. was supported in part by the UK Department for International Development and the UK Department of Health (Public Health Career Scientist award).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Glynn, J. R., Crampin, A. C., Traore, H., Chaguluka, S., Mwafulirwa, D. T., Alghamdi, S., Ngwira, B. M.M., Yates, M. D., Drobniewski, F. D., and Fine, P. E.M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Emerging Infectious Diseases
• Publisher: Centers for Disease Control and Prevention
• ISSN: 1080-6040
• ISSN (Online): 1080-6059
• Copyright Holders: Copyright © 2008 The Authors
• First Published: First published in Emerging Infectious Diseases 14(7):1060-1066
• Publisher Policy: Reproduced in accordance with the publisher copyright policy