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Molecular epidemiology of tuberculosis in Havana, Cuba, 2009
Author(s) -
González Díaz Alexander,
Battaglioli Tullia,
Díaz Rodríguez Raúl,
Goza Valdés Roxana,
González Ochoa Edilberto,
Van der Stuyft Patrick
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12569
Subject(s) - tuberculosis , epidemiology , genotyping , transmission (telecommunications) , mycobacterium tuberculosis , medicine , molecular epidemiology , population , incidence (geometry) , confidence interval , environmental health , demography , biology , genotype , pathology , genetics , physics , optics , sociology , electrical engineering , gene , engineering
Objectives To estimate the proportion of tuberculosis cases attributable to recent transmission and the risk factors possibly associated with tuberculosis clustering. Methods Population‐based study combining information from epidemiological investigation of tuberculosis cases notified to the National Tuberculosis Control Program in Havana, Cuba, in 2009 with the results of genotyping of Mycobacterium tuberculosis isolates with variable number tandem repeat of mycobacterial interspersed repetitive units ( MIRU ‐ VNTR ) typing. Results Of 186 cases, 61 were genotyped: 33 patterns and five clusters with 19, 7, 3, 2 and 2 cases were found. The proportion of cases due to recent transmission was 45% (95% confidence interval 33–58%). Routine contact investigation failed to identify a substantial number of epidemiological links. A history of living in a closed setting was strongly associated with clustering. Conclusions The proportion of cases due to recent transmission in Havana in 2009 is high. The existing control measures in closed settings should be strengthened. A study on a larger number of cases and for a longer time period should be carried out to obtain more precise estimates. Further studies on the utility and cost‐effectiveness of the addition of molecular epidemiology techniques to support the progress towards tuberculosis elimination in Cuba, a low‐incidence resource‐limited setting, are also needed.