Epidemiology
Mycobacterium tuberculosis
Seasonality
Transmission
Whole genome sequencing
Journal
The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
entrez:
29
3
2022
pubmed:
30
3
2022
medline:
30
3
2022
Statut:
epublish
Résumé
Over 10-years of whole-genome sequencing (WGS) of Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients' sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis. 511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35-3·04), There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4. Wellcome Trust, MRC, UKHSA.
Sections du résumé
Background
UNASSIGNED
Over 10-years of whole-genome sequencing (WGS) of
Methods
UNASSIGNED
Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients' sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis.
Findings
UNASSIGNED
511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35-3·04),
Interpretation
UNASSIGNED
There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4.
Funding
UNASSIGNED
Wellcome Trust, MRC, UKHSA.
Identifiants
pubmed: 35345560
doi: 10.1016/j.lanepe.2022.100361
pii: S2666-7762(22)00054-0
pmc: PMC8956939
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100361Subventions
Organisme : Medical Research Council
ID : MR/J011398/1
Pays : United Kingdom
Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
No authors declare any conflict of interests.
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