Impact of immigration on the molecular epidemiology of tuberculosis in Rhode Island.

Abstract:

:While foreign-born persons constitute only 11% of the population in the state of Rhode Island, they account for more than 65% of incident tuberculosis (TB) annually. We investigated the molecular-epidemiological differences between foreign-born and U.S.-born TB patients to estimate the degree of recent transmission and identify predictors of clustering. A total of 288 isolates collected from culture-confirmed TB cases in Rhode Island between 1995 and 2004 were fingerprinted by spoligotyping and 12-locus mycobacterial interspersed repetitive units. Of the 288 fingerprinted isolates, 109 (37.8%) belonged to 36 genetic clusters. Our findings demonstrate that U.S.-born patients, Hispanics, Asian/Pacific islanders, and uninsured patients were significantly more likely to be clustered. Recent transmission among the foreign-born population was restricted and occurred mostly locally, within populations originating from the same region. Nevertheless, TB transmission between the foreign-born and U.S.-born population should not be neglected, since 80% of the mixed clusters of foreign- and U.S.-born persons arose from a foreign-born source case. We conclude that timely access to routine screening and treatment for latent TB infection for immigrants is vital for disease elimination in Rhode Island.

journal_name

J Clin Microbiol

authors

Vanhomwegen J,Kwara A,Martin M,Gillani FS,Fontanet A,Mutungi P,Crellin J,Obaro S,Gosciminski M,Carter EJ,Rastogi N

doi

10.1128/JCM.01952-10

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

834-44

issue

3

eissn

0095-1137

issn

1098-660X

pii

JCM.01952-10

journal_volume

49

pub_type

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