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Identifying multidrug resistant tuberculosis transmission hotspots using routinely collected data

Manjourides, J, Lin, H, Shin, S, Jeffery, Caroline ORCID:, Contreras, C, Santa Cruz, J, Jave, O, Yagui, M, Asencios, L, Pagano, M and Cohen, T (2012) 'Identifying multidrug resistant tuberculosis transmission hotspots using routinely collected data'. Tuberculosis, Vol 92, Issue 3, pp. 273-9.

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In most countries with large drug resistant tuberculosis epidemics, only those cases that are at highest risk of having MDRTB receive a drug sensitivity test (DST) at the time of diagnosis. Because of this prioritized testing, identification of MDRTB transmission hotspots in communities where TB cases do not receive DST is challenging, as any observed aggregation of MDRTB may reflect systematic differences in how testing is distributed in communities. We introduce a new disease mapping method, which estimates this missing information through probability-weighted locations, to identify geographic areas of increased risk of MDRTB transmission. We apply this method to routinely collected data from two districts in Lima, Peru over three consecutive years. This method identifies an area in the eastern part of Lima where previously untreated cases have increased risk of MDRTB. This may indicate an area of increased transmission of drug resistant disease, a finding that may otherwise have been missed by routine analysis of programmatic data. The risk of MDR among retreatment cases is also highest in these probable transmission hotspots, though a high level of MDR among retreatment cases is present throughout the study area. Identifying potential multidrug resistant tuberculosis (MDRTB) transmission hotspots may allow for targeted investigation and deployment of resources.

Item Type: Article
Uncontrolled Keywords: multidrug resistant tuberculosis, Disease mapping; Antibiotic resistance; Surveillance
Subjects: QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified.
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 360 Drug therapy
Faculty: Department: Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):
Depositing User: Faye Moody
Date Deposited: 17 Sep 2012 11:36
Last Modified: 06 Feb 2018 13:04


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