The transmission of Mycobacterium tuberculosis in high burden settings

Tom A Yates; Palwasha Y Khan; Gwenan M Knight; Jonathon G Taylor; Timothy D McHugh; Marc Lipman; Richard G White; Ted Cohen; Frank G Cobelens; Robin Wood; David A J Moore; Ibrahim Abubakar

doi:10.1016/S1473-3099(15)00499-5

The transmission of Mycobacterium tuberculosis in high burden settings

Lancet Infect Dis. 2016 Feb;16(2):227-38. doi: 10.1016/S1473-3099(15)00499-5. Epub 2016 Jan 26.

Authors

Affiliations

¹ Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; Wellcome Trust Africa Centre for Population Health, Mtubatuba, South Africa, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: t.yates@ucl.ac.uk.
² Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Karonga Prevention Study, Chilumba, Malawi.
³ Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Modelling Group, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK.
⁴ UCL Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK.
⁵ Centre for Clinical Microbiology, University College London, London, UK.
⁶ Division of Medicine, University College London, London, UK.
⁷ Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Modelling Group, London School of Hygiene & Tropical Medicine, London, UK.
⁸ Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
⁹ Department of Global Health, Academic Medical Center, Amsterdam, Netherlands; KNCV Tuberculosis Foundation, The Hague, Netherlands.
¹⁰ Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
¹¹ Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
¹² Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; MRC Clinical Trials Unit at University College London, University College London, London, UK.

PMID: 26867464
DOI: 10.1016/S1473-3099(15)00499-5

Abstract

Unacceptable levels of Mycobacterium tuberculosis transmission are noted in high burden settings and a renewed focus on reducing person-to-person transmission in these communities is needed. We review recent developments in the understanding of airborne transmission. We outline approaches to measure transmission in populations and trials and describe the Wells-Riley equation, which is used to estimate transmission risk in indoor spaces. Present research priorities include the identification of effective strategies for tuberculosis infection control, improved understanding of where transmission occurs and the transmissibility of drug-resistant strains, and estimates of the effect of HIV and antiretroviral therapy on transmission dynamics. When research is planned and interventions are designed to interrupt transmission, resource constraints that are common in high burden settings-including shortages of health-care workers-must be considered.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Air Microbiology
Communicable Disease Control / methods*
Cross Infection / prevention & control*
Disease Transmission, Infectious
Health Personnel
Humans
Mycobacterium tuberculosis
Tuberculosis / transmission*

Abstract

Publication types

MeSH terms

Grants and funding