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Volume 18, Number 3—March 2012

Research

Using Genotyping and Geospatial Scanning to Estimate Recent Mycobacterium tuberculosis Transmission, United States

Patrick K. MoonanComments to Author , Smita Ghosh, John E. Oeltmann, J. Steven Kammerer, Lauren S. Cowan, and Thomas R. Navin
Author affiliations: US Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

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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