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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Mycobacterium tuberculosis transmission in a country with low tuberculosis incidence: Role of immigration and HIV infection
Journal of Clinical Microbiology, Volume 50, No. 2, Year 2012
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Description
Immigrants from high-burden countries and HIV-coinfected individuals are risk groups for tuberculosis (TB) in countries with low TB incidence. Therefore, we studied their role in transmission of Mycobacterium tuberculosis in Switzerland. We included all TB patients from the Swiss HIV Cohort and a sample of patients from the national TB registry. We identified molecular clusters by spoligotyping and mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) analysis and used weighted logistic regression adjusted for age and sex to identify risk factors for clustering, taking sampling proportions into account. In total, we analyzed 520 TB cases diagnosed between 2000 and 2008; 401 were foreign born, and 113 were HIV coinfected. The Euro-American M. tuberculosis lineage dominated throughout the study period (378 strains; 72.7%), with no evidence for another lineage, such as the Beijing genotype, emerging. We identified 35 molecular clusters with 90 patients, indicating recent transmission; 31 clusters involved foreign-born patients, and 15 involved HIV-infected patients. Birth origin was not associated with clustering (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 0.73 to 3.43; P∇0.25, comparing Swiss-born with foreign-born patients), but clustering was reduced in HIV-infected patients (aOR, 0.49; 95% CI, 0.26 to 0.93; P∇0.030). Cavitary disease, male sex, and younger age were all associated with molecular clustering. In conclusion, most TB patients in Switzerland were foreign born, but transmission of M. tuberculosis was not more common among immigrants and was reduced in HIV-infected patients followed up in the national HIV cohort study. Continued access to health services and clinical follow-up will be essential to control TB in this population. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Fenner, Lukas
Switzerland, Bern
University of Bern
Gagneux, Sébastien P.
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Helbling, Peter
Switzerland, Bern
Federal Office of Public Health Foph
Battegay, Manuel
Switzerland, Basel
Universitätsspital Basel
Rieder, Hans L.
Switzerland, Zurich
Universität Zürich
France, Paris
The Union
Pfyffer, Gaby E.
Unknown Affiliation
Zwahlen, Marcel
Switzerland, Bern
University of Bern
Furrer, Hansjakob
Switzerland, Bern
University of Bern
Fehr, Jan Sven
Switzerland, Zurich
Universität Zürich
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Stucki, David
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Jaton, Katia
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Janssens, Jean Paul
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Stalder, Jesica Mazza
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Bödmer, Thomas
Switzerland, Bern
University of Bern
Böttger, Erik Christian
Switzerland, Zurich
Universität Zürich
Egger, Matthias
Switzerland, Bern
University of Bern
Statistics
Citations: 43
Authors: 17
Affiliations: 10
Identifiers
Doi:
10.1128/JCM.05392-11
ISSN:
1098660X
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Male