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Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana

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ABSTRACT

During 2012–2015, 10 of 24 patients infected with matching genotypes of Mycobacterium tuberculosis received care at the same hospital in Gaborone, Botswana. Nosocomial transmission was initially suspected, but we discovered plausible sites of community transmission for 20 (95%) of 21 interviewed patients. Active case-finding at these sites could halt ongoing transmission.

No MeSH data available.


Related in: MedlinePlus

Residence-associated data for patients in a tuberculosis cluster, Gaborone, Botswana, 2012–2015. A) Primary residences of 20 patients are indicated by red dots. Inset map shows location of Gaborone in Botswana. Black lines demarcate neighborhoods; gray lines demarcate property parcels; pink circles represent 0.5-km radius around a patient’s residence; and red rectangles indicate presence of 14 patients in 4 distinct neighborhoods, 13 of whom had spatial links. Four patients who are not depicted on this map lived outside of Gaborone and did not have any spatial links between them. B) Primary residences of 5 patients who lived in the same neighborhood. Parcels locations were intentionally not shown to protect individual case anonymity. Geodata were sourced from Statistics Botswana (http://www.cso.gov.bw).
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Figure 2: Residence-associated data for patients in a tuberculosis cluster, Gaborone, Botswana, 2012–2015. A) Primary residences of 20 patients are indicated by red dots. Inset map shows location of Gaborone in Botswana. Black lines demarcate neighborhoods; gray lines demarcate property parcels; pink circles represent 0.5-km radius around a patient’s residence; and red rectangles indicate presence of 14 patients in 4 distinct neighborhoods, 13 of whom had spatial links. Four patients who are not depicted on this map lived outside of Gaborone and did not have any spatial links between them. B) Primary residences of 5 patients who lived in the same neighborhood. Parcels locations were intentionally not shown to protect individual case anonymity. Geodata were sourced from Statistics Botswana (http://www.cso.gov.bw).

Mentions: Twenty (83%) patients had a primary residence in Gaborone; 14 resided in 4 distinct neighborhoods (Figure 2, panel A). The spatial link definition (residing <1 km from another cluster-associated patient) was met by 13 (54%) patients. One patient (B) lived slightly >1 km from the nearest patient (Figure 2, panel B). Two of 4 spatially linked patients (C, D, I, and W) (Figure 2, panel B) did not name each other during enrollment when asked about contacts; when interviewed again as part of this investigation, these patients confirmed spending time together around the time of their diagnosis.


Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana
Residence-associated data for patients in a tuberculosis cluster, Gaborone, Botswana, 2012–2015. A) Primary residences of 20 patients are indicated by red dots. Inset map shows location of Gaborone in Botswana. Black lines demarcate neighborhoods; gray lines demarcate property parcels; pink circles represent 0.5-km radius around a patient’s residence; and red rectangles indicate presence of 14 patients in 4 distinct neighborhoods, 13 of whom had spatial links. Four patients who are not depicted on this map lived outside of Gaborone and did not have any spatial links between them. B) Primary residences of 5 patients who lived in the same neighborhood. Parcels locations were intentionally not shown to protect individual case anonymity. Geodata were sourced from Statistics Botswana (http://www.cso.gov.bw).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5382725&req=5

Figure 2: Residence-associated data for patients in a tuberculosis cluster, Gaborone, Botswana, 2012–2015. A) Primary residences of 20 patients are indicated by red dots. Inset map shows location of Gaborone in Botswana. Black lines demarcate neighborhoods; gray lines demarcate property parcels; pink circles represent 0.5-km radius around a patient’s residence; and red rectangles indicate presence of 14 patients in 4 distinct neighborhoods, 13 of whom had spatial links. Four patients who are not depicted on this map lived outside of Gaborone and did not have any spatial links between them. B) Primary residences of 5 patients who lived in the same neighborhood. Parcels locations were intentionally not shown to protect individual case anonymity. Geodata were sourced from Statistics Botswana (http://www.cso.gov.bw).
Mentions: Twenty (83%) patients had a primary residence in Gaborone; 14 resided in 4 distinct neighborhoods (Figure 2, panel A). The spatial link definition (residing <1 km from another cluster-associated patient) was met by 13 (54%) patients. One patient (B) lived slightly >1 km from the nearest patient (Figure 2, panel B). Two of 4 spatially linked patients (C, D, I, and W) (Figure 2, panel B) did not name each other during enrollment when asked about contacts; when interviewed again as part of this investigation, these patients confirmed spending time together around the time of their diagnosis.

View Article: PubMed Central - PubMed

ABSTRACT

During 2012&ndash;2015, 10 of 24 patients infected with matching genotypes of Mycobacterium tuberculosis received care at the same hospital in Gaborone, Botswana. Nosocomial transmission was initially suspected, but we discovered plausible sites of community transmission for 20 (95%) of 21 interviewed patients. Active case-finding at these sites could halt ongoing transmission.

No MeSH data available.


Related in: MedlinePlus