Combining molecular typing and spatial pattern analysis to identify areas of high tuberculosis transmission in a moderate-incidence county in Taiwan

• Published in: Scientific reports Vol. 7; no. 1; pp. 5394 - 8
• Main Authors: Chen, Yih-Yuan, Chang, Jia-Ru, Wu, Chih-Da, Yeh, Yen-Po, Yang, Shiu-Ju, Hsu, Chih-Hao, Lin, Ming-Ching, Tsai, Ching-Fang, Lin, Ming-Shian, Su, Ih-Jen, Dou, Horng-Yunn
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.07.2017; Nature Publishing Group; Nature Portfolio
• Subjects: 45/22; 45/29; 45/77; 692/308/174; 692/699/255/1856; Adult; Age Factors; Aged; Bacterial Typing Techniques; Disease hot spots; Disease transmission; Environmental factors; Environmental Monitoring; Female; Geographic Information Systems; Humanities and Social Sciences; Humans; Incidence; Male; Middle Aged; Minisatellite Repeats; multidisciplinary; Mycobacterium tuberculosis - classification; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Population Density; Retrospective Studies; Risk Factors; Science; Science (multidisciplinary); Taiwan - epidemiology; Tuberculosis; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - microbiology; Tuberculosis, Pulmonary - transmission; Taiwan; Beijing China; China
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-05674-6

In total, 303 randomly selected clinical Mycobacterium tuberculosis (MTB) isolates from 303 patients (collected January to December 2012) in central Taiwan were examined. The major lineages found were Beijing (N = 114, 37.62%), Haarlem (N = 76, 25.08%) and East African–Indian (EAI) (N = 42, 13.86%). Notably, younger persons (≤30 years old) were 6.58 times more likely to be infected with a Beijing genotype compared to older persons (>70 years) (p < 0.05). Combining molecular typing methods and geographical information system (GIS) analysis, we uncovered a twofold higher incidence of Beijing strains in a hotspot area (33%) compared to non-hotspot areas (17%). By 24 MIRU-VNTR typing, persons in clustered groups were 1.96 times more likely to be infected with a Beijing strain compared with non-clustered persons, suggesting recent spread and emergence of MTB. Finally, we observed a trend in which TB incidence increased as the density/concentration of analyzed environmental factors increased, suggesting that environmental factors are associated with TB transmission; however, only population density was found to be significantly associated with increased risk of TB (p < 0.05). Molecular typing methods combined with spatial analysis suggest possible TB transmission. Early intervention to interrupt transmission may be most effective if targeted to hot zones of TB.