Volume 18, Number 3—March 2012
Research
Using Genotyping and Geospatial Scanning to Estimate Recent Mycobacterium tuberculosis Transmission, United States
Patrick K. Moonan
, Smita Ghosh, John E. Oeltmann, J. Steven Kammerer, Lauren S. Cowan, and Thomas R. Navin
, Smita Ghosh, John E. Oeltmann, J. Steven Kammerer, Lauren S. Cowan, and Thomas R. Navin
Table 1
Demographic, behavioral, and clinical characteristics of persons involved in putative recent TB transmission events, United States, 2005–2009*
| Variable | No. (%) clustered† | Total no. available | Crude OR (99% CI) | Adjusted OR (99% CI)‡ |
|---|---|---|---|---|
| Sex, n = 36,852 | ||||
| M | 5,634 (66.3) | 23,136 | 1.2 (1.1–1.3) | 1.1 (1.0–1.2) |
| F | 2,862 (33.7) | 13,716 | ||
| Age group, y, n = 36,860 | ||||
| 0–4 | 206 (02.4) | 395 | 3.5 (2.7–4.6) | 3.1 (1.4–6.8) |
| 5–14 | 99 (01.2) | 333 | 1.4 (1.0–1.9) | 1.2 (0.8–1.9) |
| 15–24 | 1,131 (13.3) | 4,488 | 1.1 (1.0–1.2) | 1.1 (1.0–1.3) |
| 25–44 | 2,975 (35.0) | 12,688 | Referent | |
| 45–64 | 3,025 (35.6) | 11,247 | 1.0 (1.1–1.3) | 1.0 (0.9–1.0) |
| >65 | 1,063 (12.5) | 7,709 | 0.5 (0.5–0.6) | 0.5 (0.4–0.6) |
| Race/ethnicity, n = 36,761 | ||||
| American Indian/Alaska Native | 111 (01.3) | 498 | 1.4 (0.9–1.5) | 0.8 (0.6–1.2) |
| Asian, non-Hispanic | 1,496 (17.6) | 9,922 | 0.7 (0.6–0.8) | 1.5 (1.3–1.8) |
| Black, non-Hispanic | 3,368 (39.7) | 9,471 | 2.2 (2.0–2.4) | 2.4 (2.2–2.7) |
| Hispanic/Latino | 2,165 (25.5) | 10,238 | 1.1 (1.0–1.2) | 1.7 (1.5–2.0) |
| Native Hawaiian/Pacific Islander | 59 (0.7) | 190 | 1.8 (1.2–2.7) | 2.6 (1.5–4.4) |
| White, non-Hispanic | 1,272 (15.0) | 6,335 | Referent | § |
| Other | 16 (0.2) | 107 | 0.7 (0.3–1.4) | 0.9 (0.4–2.2) |
| Country of birth, n = 36,745 | ||||
| United States | 4,871 (57.4) | 14,594 | 2.6 (2.4–2.7) | 2.4 (2.1–2.7) |
| Non–US-born | 3,611 (42.6) | 22,151 | ||
| In US <2 y | 1,100 (30.5) | 7,675 | Referent | ** |
| In US 2–5 y | 531 (14.7) | 3,326 | 1.1 (1.0–1.3) | |
| In US >5 y | 1,980 (54.8) | 11,150 | 1.3 (1.2–1.4) | |
| Homelessness within past 12 mo, n = 36,558 | ||||
| Yes | 946 (11.2) | 2,361 | 2.4 (2.1–2.7) | 1.4 (1.2–1.6) |
| No | 7,488 (88.8) | 34,197 | ||
| Substance abuse within past 12 mo, n = 36,860 | ||||
| Yes | 2,415 (28.4) | 6,623 | 2.3 (2.1–2.5) | 1.4 (1.3–1.7) |
| No | 6,082 (71.6) | 30,237 | ||
| Residence at correctional facility at time of diagnosis, n = 36,815 | ||||
| Yes | 369 (04.3) | 1,400 | 1.2 (1.0–1.4) | 0.8 (0.7–1.0) |
| No | 8,121 (95.7) | 35,415 | ||
| Residence at a long-term care facility at time of diagnosis, n = 36,801 | ||||
| Yes | 180 (02.1) | 800 | 1.0 (0.8–1.2) | NS |
| No | 8,304 (97.9) | 36,001 | ||
| Reported HIV status, n = 36,860 | ||||
| Positive | 741 (08.7) | 2,290 | 1.7 (1.5–1.9) | 1.1 (1.0–1.3) |
| Not positive | 7,756 (91.3) | 34,570 | ||
| Clinical presentation of TB, n = 36,779 | ||||
| Pulmonary only | 6,653 (78.4) | 27,083 | 1.6 (1.5–1.8) | 1.2 (1.0–1.4) |
| Extrapulmonary only | 992 (11.7) | 5,973 | Referent | |
| Pulmonary and extrapulmonary | 841 (09.9) | 3,723 | 1.5 (1.3–1.7) | 1.0 (0.8–1.3) |
| Sputum smear positivity, n = 31,625 | ||||
| Yes | 4,640 (61.5) | 17,934 | 1.3 (1.2, 1.4) | 1.1 (1.0–1.2) |
| No | 2,903 (38.5) | 13,691 | ||
| Cavitary chest radiograph, n = 31,382 | ||||
| Yes | 2,782 (36.8) | 10,411 | 1.2 (1.2–1.3) | 1.0 (0.9–1.1) |
| No | 4,771 (63.2) | 20,971 | ||
| Previous TB diagnosis, n = 36,544 | ||||
| Yes | 426 (05.0) | 1,680 | 1.1 (1.0–1.3) | NS |
| No | 8,010 (95.0) | 34,864 | ||
| Mycobacterium tuberculosis or other species spoligotype-based lineage, n = 36,458 | ||||
| East African Indian | 197 (02.3) | 1,582 | Referent | |
| East Asian | 1,259 (14.9) | 4,924 | 2.4 (1.9–3.0) | 1.9 (1.5–2.6) |
| Euro-American | 5,857 (69.2) | 23,441 | 2.3 (1.9–2.8) | 1.5 (1.2–2.0) |
| Indo-Oceanic | 1,000 (11.8) | 5,760 | 1.5 (1.2–1.8) | 1.7 (1.3–2.3) |
| M. africanum | 25 (0.3) | 179 | 1.1 (0.6–2.0) | 0.8 (0.4–1.7) |
| M. bovis | 127 (01.5) | 572 | 2.0 (1.4–2.8) | 2.0 (1.3–3.2) |
*n values indicate number of persons for whom information in category was available. TB, tuberculosis; OR, odds ratio; NS, not significant. Boldface indicates significance at α = 0.01.
†Genotype clustering: >2 cases with identical spoligotype and 12-loci mycobacterial interspersed repetitive unit–variable-number tandem repeat genotypes occurring within a geospatially concentrated area identified by SaTScan (20). Cases must have clustered at least once in 1 of 3 consecutive, overlapping years (scan A, 2005–2007; scan B, 2006–2008; scan C, 2007–2009) (scan windows spatially limited to 50 km).
‡Final model, n = 31,382.
§Not included in the model to include both US-born and non–US-born case-patients.
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