Published ahead of print on May 25, 2006, doi:10.1164/rccm.200512-1977OC Am. J. Respir. Crit. Care Med., Volume 174, Number 5, September 2006, 599-604 A more recent version of this article appeared on September 1, 2006
Submitted on December 29, 2005 What is the Outcome of Location-based Targeted Tuberculosis Screening Based on Universal Genotyping?Patrick K Moonan1,1 School of Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA; School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA; Tarrant County Public Health Department, Fort Worth, Texas, USA, 2 Department of Geography, University of North Texas, Denton, Texas, USA, 3 School of Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA; School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA; Bureau of Tuberculosis Elimination, Texas Department of Health and Human Services, Austin, Texas, USA, 4 School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA, 5 School of Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA; Tarrant County Public Health Department, Fort Worth, Texas, USA, 6 Tarrant County Public Health Department, Fort Worth, Texas, USA, 7 School of Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA; School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA, 8 Department of Microbiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA, 9 Bureau of Tuberculosis Elimination, Texas Department of Health and Human Services, Austin, Texas, USA * To whom correspondence should be addressed. E-mail: sweis{at}hsc.unt.edu.
Rationale and Objectives: Identifying and treating persons with latent tuberculosis infection (LTBI) at high risk for developing tuberculosis is part of current tuberculosis elimination strategy. There are no specific criteria, other than medical risks, to designate groups as high-risk for developing tuberculosis. We hypothesized that if location-based screenings were done in communities where persons with genotypically clustered M. tuberculosis resided, then persons with LTBI from recent transmission and with undiagnosed tuberculosis could be identified. Methods: Location-based tuberculosis 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 tuberculosis for every 83 screened and one person with latent tuberculosis infection for every 5 screened. The yield of this targeted screening program for discovering persons with tuberculosis and LTBI exceeded what would be expected from non-targeted screening in a county with a tuberculosis incidence of 5.7 per 100,000 population year. Conclusions: Genotyping combined with Geographic Information Systems (GIS) analysis can potentially be used to define high-risk status and to define areas for location-based tuberculosis-screenings. Key words: genotyping, M. tuberculosis, location-based screening
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