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Volume 8, Number 11—November 2002
THEME ISSUE
Tuberculosis Genotyping

Tuberculosis Genotyping Network, United States

Molecular Epidemiology of Tuberculosis in a Sentinel Surveillance Population

Barbara A. Ellis*Comments to Author , Jack T. Crawford*, Christopher R. Braden*, Scott J. N. McNabb*, Marisa Moore*, Steve Kammerer*, and the National Tuberculosis Genotyping and Surveillance Network Work Group
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

Table 3

Comparison of demographic and behavioral risk factors and clinical and treatment outcomes of tuberculosis (TB) case-patients who have genetically clustered genotypes with factors and outcomes of patients who had unique genotype patternsa

Variableb Clustered (%) Unclustered (%) Relative risk (95% CI) Probabilityc
Total cases (n=10,752) 5.171(48.1) 5,581 (51.9)
Gender Male 3,289 (63.6) 3,107 (55.7) 1.19 (1.14% to 1.24%) <0.001
Female 1,881 (36.4) 2,473 (44.3)
Unknown 1 (0.0) 1 (0.0)
Mean age (yrs; ±S.E.) 44.8 (±0.26) 49.4 (±0.28) <0.0001
Race/ethnicity White, non-Hispanic 1,018 (19.7) 1,201 (21.5) 0.94 (0.90% to 0.99%) 0.02
Black, non-Hispanic 2,254 (43.6) 1,237 (22.2) 1.61 (1.55% to 1.67%) <0.001
Hispanic 914 (17.7) 1,112 (19.9) 0.92 (0.88% to 0.97%) 0.003
American Indian/Native 17 (0.3) 10 (0.2)
Asian/Pacific Islander 961 (18.6) 2,014 (36.1) 0.60 (0.56% to 0.63%) <0.001
Unknown 7 (0.1) 7 (0.1) 0.59 (0.55% to 0.63%)
Place of birth U.S.-born 3,331 (64.4) 2,023 (36.2) 1.83 (1.75% to 1.90%) <0.001
Foreign-born 1,825 (35.3) 3,552 (63.6)
Unknown 15 (0.3) 6 (0.1)
Recent to United Statesd Yes 535 (29.3) 1,225 (34.5) 2,111 (59.4) <0.001
No 1,181 (64.7)
Unknown 109 (6.0) 216 (6.1)
Site of disease Pulmonary 3,902 (75.5) 3,835 (68.7) 1.20 (1.14% to1.26%) <0.001
Extrapulmonary 788 (15.2) 1,254 (22.5) 0.77 (0.72% to 0.81%) <0.001
Pulmonary and extrapulmonary 476 (9.2) 492 (8.8) NS
Unknown 5 (0.1) 0
Sputum smear Positive 2,270 (43.9) 2,011 (36.0) 1.22 (1.11% to 1.33%) <0.001
Negative 1,802 (34.8) 1,943 (34.8)
Not done/unknown 1,099 (21.3) 1,627 (29.1)
Chest radiographe Cavitary 1,345 (30.7) 1,172 (27.1) 1.09 (1.04% to 1.14%) <0.001
Noncavitary 2,639 (60.2) 2,826 (65.3)
Normal 146 (3.3) 118 (2.73)
Not done/unknown 253 (5.8) 211 (4.9)
Total 4,383 4,327
HIV statusf Positive 458 (22.2) 223 (11.8) 1.37 (1.29% to 1.46%) <0.001
Negative 978 (47.4) 847 (44.8) NS
Indeterminate 0 4 (0.2)
Refused 106 (5.1) 138 (7.3)
Not offered 252 (12.2) 354 (18.7)
Unknown 270 (13.0) 323 (17.1)
Total 2,064 1,889
Homeless within past year Yes 370 (7.2) 139 (2.5) 1.55 (1.46% to 1.64% <0.001
No 4,724 (91.4) 5,370 (96.2)
Unknown 77 (1.5) 72 (1.3)
Resident of correctional facility at diagnosis Yes 190 (3.7) 69 (1.2) 1.55 (1.43% to 1.67%) <0.001
No 4,966 (96.0) 5,503 (98.6)
Unknown 15 (0.3) 9 (0.2)
Injecting drug useg Yes 312 (6.0) 72 (1.3) 1.73 (1.65% to 1.83%) <0.001
No 4,540 (87.8) 5,231 (93.7)
Unknown 319 (6.2) 278 (5.0)
Noninjecting drug useg Yes 460 (8.9) 140 (2.5) 1.65 (1.57% to 1.73%) <0.001
No 4,335 (83.8) 5,140 (92.1)
Unknown 376 (7.3) 301 (5.4)
Excessive alcohol useg Yes 948 (18.3) 371 (6.6) 1.61 (1.54% to 1.67%) <0.001
No 3,897 (75.4) 4,893 (87.7)
Unknown 326 (6.3) 317 (5.7)
First-line drugs h
Yes 622 (12.1) 755 (13.7) 0.93 (0.87% to 0.99%) 0.016
No 2,718 (53.0) 3,337 (60.5)
Not done 1,748 (34.1) 1,356 (24.6)
Unknown 45 (0.9 66 (1.2)
Total 5,133 5,514

aCI, confidence interval; S.E., standard error.
bOnly factors that had significant differences are shown.
cProbability of chi-square statistic is shown, except for t-test results from analysis of age from each group.
dForeign-born only; arrived in the United States within 2 years.
eExcludes cases with extrapulmonary TB only.
fCalifornia TB cases not included; ages 15–44 years only.
gExcessive drug or alcohol use within last year.
hFirst-line drug resistance is resistance to at least one of the following: isoniazid, rifampin, ethambutol, or streptomycin. Second-line drug resistance is resistance to one or more of the following: ethionamide, kanamycin, cycloserine, capreomycin, para-amino salicylic acid, amikacin, rifabutin, ciprofloxacin, ofloxacin, or other drugs. Testing results for one or more of the drugs could have been missing.

Main Article

1 Members of the National Tuberculosis Genotyping and surveillance Network Work Group, in addition to the listed authors, included Joseph Bates, William Benjamin, Pablo Bifani, M. Donald Cave, Rebecca Cox, Wendy Cronin, Ed Desmond, Jeffrey Driscoll, Nancy Dunlap, Jennifer Flood, Kashef Ijaz,, Michael Kucab, Barry Kreiswirth, Zary Liu, D. Mitchell Magee, Jeffrey Massey, Ann Miller, Donna Mulcahy, Robert Pratt, Teresa Quitugua, Barbara Schable, Kenneth Shilkret, Harry Taber, Jeffrey Taylor, Sharon Sharnprapai, Sumi Sun, Zhenhua Yang

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