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What Is the Outcome of Targeted Tuberculosis Screening Based on Universal Genotyping and Location?

Schools of Medicine and Public Health, University of North Texas Health Science Center at Fort Worth; Tarrant County Public Health Department, Fort Worth; Department of Geography, University of North Texas, Denton; Department of Microbiology, University of Texas Health Science Center at San Antonio, San Antonio; and the Bureau of Tuberculosis Elimination, Texas Department of Health and Human Services, Austin, Texas

Correspondence and requests for reprints should be addressed to Stephen E. Weis, D.O., University of North Texas Health Science Center at Fort Worth, Patient Care Center, 855 Montgomery, Fort Worth, TX 76107. E-mail: sweis{at}hsc.unt.edu

Rationale and Objectives: Identifying and treating persons with latent tuberculosis (TB) infection (LTBI) at high risk for developing TB is part of the current TB elimination strategy. There are no specific criteria, other than medical risks, to designate groups as high risk for developing TB. We hypothesized that, if location-based screenings were done in communities where persons with genotypically clustered Mycobacterium tuberculosis resided, then persons with LTBI from recent transmission and with undiagnosed TB could be identified.

Methods: Location-based TB screenings were done in partnership with multiple community-based organizations using resources previously used for other types of screening.

Main Results: Location-based screenings identified one person with TB for every 83 screened, and one person with LTBI for every five screened. The yield of this targeted screening program for discovering persons with TB and LTBI exceeded what would be expected from nontargeted screening in a county with a TB incidence of 5.7 per 100,000 population.

Conclusions: Genotyping combined with geographic information systems analysis can potentially be used to define high-risk status and to define areas for location-based TB screenings.

Key Words: genotyping • location-based screening • Mycobacterium tuberculosis

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