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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Richard B. Rothenberg, MD, MPH, Department of Family and Preventive Medicine, Emory University School of Medicine, 69 Butler Street, SE, Atlanta, GA 30303, 404-616-5606, rrothen@emory.edu
Background: To elucidate networks of Mycobacterium tuberculosis transmission, it may be appropriae to characterize the types of relationships among tuberculosis (TB) cases and their contacts in addition to the traditional effort to distinguish "close" from "casual" contacts. Setting: A TB outbreak in a low incidence US state. Objective: To evaluate whether methods of social network analysis can provide insights to transmission milieu that go unrecognized by routine practices. Design: All adult outbreak-associated cases (n=19) and a convenience sample of their contacts with and without latent TB infection (LTBI) (n=26) were re-interviewed in 2001 using a structured questionnaire. Network analysis software was used to visualize important persons within the outbreak network, as well as types of activites TB cases engaged in with their contacts. Results: Drug-use by cases and drug-sharing among cases and their named contacts were more commonly reported in comparison to interviewed contacts without LTBI. TB cases central to the outbreak network used crack-cocaine, demonstrating the need to focus control efforts to specific sites and persons involved in illicit drug use. Conclusion: Even in areas with low TB incidence, outbreaks occur among groups where drug-use and other illegal activity complicate control efforts. TB programs should consider the use of network analysis to supplement routine contact investigations in order to identify unrecognized patterns of M. tuberculosis transmission.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.