American Journal of Epidemiology Vol. 154, No. 10 : 934-943
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Transmission of Mycobacterium tuberculosis Depending on the Age and Sex of Source Cases
1 Royal Netherlands Tuberculosis Association, The Hague, the Netherlands.
2 Institute of Public Health, Erasmus University, Rotterdam, the Netherlands.
3 Bureau for Informatics and Methodological Support, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
4 Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
This study estimated to what extent tuberculosis transmission in the Netherlands depends on the age and sex of source cases. DNA fingerprints of Mycobacterium tuberculosis isolates were matched to patient information in the Netherlands Tuberculosis Register for 1993–1998. Clusters were defined as groups of patients with pulmonary tuberculosis whose isolates had identical DNA fingerprints. Source cases were assigned by using two models. The first-case model assumed that the first diagnosed case was the source case. The incidence rate model estimated source case probabilities from the incidence rates of potential source cases and the time of diagnosis. DNA fingerprints of 6,102 isolates were matched to patient information on 5,080 (83%) cases, 3,479 of whom had pulmonary disease. According to both models, the number of infectious cases generated per source case was lower for female than for male source cases and decreased with increasing age of the source case. The authors concluded that transmission of tuberculosis is associated with the age and sex of source cases as well as the age of secondary cases. Increased transmission among immigrant groups in the Netherlands is largely attributable to the relatively young age of immigrant source cases.
age distribution; polymorphism, restriction fragment length; sex; tuberculosis, pulmonary
Abbreviations: IS, insertion sequence; Ps, probability that a clustered case was the original source case of the cluster; Pt, probability that a potential source case will give rise to a cluster; RFLP, restriction fragment length polymorphism
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