Identifying hotspots of multidrug resistant tuberculosis transmission using spatial and molecular genetic data - Incite at Columbia University

A team of Robert Wood Johnson Foundation Health & Society Scholars, led by Dr. Jonathan Zelner, published a study in the Journal of Infectious Diseases.

The authors aimed to identify and determine the etiology of ‘hotspots’ of concentrated multi-drug resistant tuberculosis (MDR-TB) risk in Lima, Peru. Methods: From 2009-2012, we conducted a prospective cohort study among households of TB cases from 106 health center (HC) areas in Lima, Peru. All notified TB cases and their household contacts were recruited and followed for one year. Individuals with TB symptoms were screened by microscopy and culture; positive cultures were tested for drug susceptibility (DST) and genotyped by 24-loci MIRU-VNTR.

Findings reveal that localized transmission is an important driver of the epidemic of MDR-TB in Lima. Efforts to interrupt transmission may be most effective if targeted to this area of the city.