Abstract:
BACKGROUND:The "fitness" of an infectious pathogen is defined as the ability of the pathogen to survive, reproduce, be transmitted, and cause disease. The fitness of multidrug-resistant tuberculosis (MDRTB) relative to drug-susceptible tuberculosis is cited as one of the most important determinants of MDRTB spread and epidemic size. To estimate the relative fitness of drug-resistant tuberculosis cases, we compared the incidence of tuberculosis disease among the household contacts of MDRTB index patients to that among the contacts of drug-susceptible index patients. METHODS AND FINDINGS:This 3-y (2010-2013) prospective cohort household follow-up study in South Lima and Callao, Peru, measured the incidence of tuberculosis disease among 1,055 household contacts of 213 MDRTB index cases and 2,362 household contacts of 487 drug-susceptible index cases. A total of 35/1,055 (3.3%) household contacts of 213 MDRTB index cases developed tuberculosis disease, while 114/2,362 (4.8%) household contacts of 487 drug-susceptible index patients developed tuberculosis disease. The total follow-up time for drug-susceptible tuberculosis contacts was 2,620 person-years, while the total follow-up time for MDRTB contacts was 1,425 person-years. Using multivariate Cox regression to adjust for confounding variables including contact HIV status, contact age, socio-economic status, and index case sputum smear grade, the hazard ratio for tuberculosis disease among MDRTB household contacts was found to be half that for drug-susceptible contacts (hazard ratio 0.56, 95% CI 0.34-0.90, p = 0.017). The inference of transmission in this study was limited by the lack of genotyping data for household contacts. Capturing incident disease only among household contacts may also limit the extrapolation of these findings to the community setting. CONCLUSIONS:The low relative fitness of MDRTB estimated by this study improves the chances of controlling drug-resistant tuberculosis. However, fitter multidrug-resistant strains that emerge over time may make this increasingly difficult.
journal_name
PLoS Medjournal_title
PLoS medicineauthors
Grandjean L,Gilman RH,Martin L,Soto E,Castro B,Lopez S,Coronel J,Castillo E,Alarcon V,Lopez V,San Miguel A,Quispe N,Asencios L,Dye C,Moore DAdoi
10.1371/journal.pmed.1001843subject
Has Abstractpub_date
2015-06-23 00:00:00pages
e1001843; discussion e1001843issue
6eissn
1549-1277issn
1549-1676pii
PMEDICINE-D-14-03825journal_volume
12pub_type
杂志文章相关文献
PLOS MEDICINE文献大全abstract:BACKGROUND:Undiagnosed and misdiagnosed tuberculosis (TB) drives the epidemic in India. Serological (antibody detection) TB tests are not recommended by any agency, but widely used in many countries, including the Indian private sector. The cost and impact of using serology compared with other diagnostic techniques is ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001074
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Spurred by the creation of potential modified risk tobacco products, the US Food and Drug Administration (FDA) commissioned the Institute of Medicine (IOM) to assess the science base for tobacco "harm reduction," leading to the 2001 IOM report Clearing the Smoke. The objective of this study was to determine ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001450
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is to evaluate the clinical and economic impact of point-of-care CD4 tests compared to laboratory-based tests in Mozambique. METHODS AND FINDINGS:We use a validated model of HIV testing, linkag...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001725
更新日期:2014-09-16 00:00:00
abstract:BACKGROUND:Diabetes is a well-known risk factor for tuberculosis (TB) and is increasingly prevalent in low- and middle-income countries, where the burden of TB is high. Glycemic control has the potential to modify the risk of TB. However, there are few studies on the association between glycemic control and TB risk, an...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002072
更新日期:2016-08-09 00:00:00
abstract:BACKGROUND TO THE DEBATE:The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus) is less hazardous to health than smoking tobacco. Proponents of "harm reduction" point to the Swedish experience. Snus seems to be widely used as an alternative to c...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0040185
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Socioeconomic adversity in early life has been hypothesized to "program" a vulnerable phenotype with exaggerated inflammatory responses, so increasing the risk of developing type 2 diabetes in adulthood. The aim of this study is to test this hypothesis by assessing the extent to which the association between...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001479
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Glioblastoma multiforme (GBM) is the most lethal form of brain cancer. With the available treatments, survival does not exceed 12-14 mo from the time of diagnosis. We describe a novel strategy to selectively induce the death of glioblastoma cells and other cancer cells that over-express the EGF receptor. Usi...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030006
更新日期:2006-01-01 00:00:00
abstract::Nathan Ford and Gottfried Hirnschall reflect on recent research by Jan Hontelez and colleagues published in this week's PLOS Medicine. The authors argue that the future HIV modeling efforts should focus on helping programs make choices about which interventions need to be prioritized in order to achieve the levels of ...
journal_title:PLoS medicine
pub_type: 评论,杂志文章
doi:10.1371/journal.pmed.1001535
更新日期:2013-10-01 00:00:00
abstract::How do we spot the next sexually transmitted infection? Kyle Bernstein and colleagues look for lessons from past discovery. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002474
更新日期:2017-12-27 00:00:00
abstract:BACKGROUND:Obesity is associated with low-grade chronic inflammation, and serum markers of inflammation are independent risk factors for cardiovascular disease (CVD). However, the molecular and cellular mechanisms that link obesity to chronic inflammation and CVD are poorly understood. METHODS AND FINDINGS:Acute-phase...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030287
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Average profiles of salivary progesterone in women vary significantly at the inter- and intrapopulation level as a function of age and acute energetic conditions related to energy intake, energy expenditure, or a combination of both. In addition to acute stressors, baseline progesterone levels differ among p...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0040167
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Although it has long been appreciated that ovarian carcinoma subtypes (serous, clear cell, endometrioid, and mucinous) are associated with different natural histories, most ovarian carcinoma biomarker studies and current treatment protocols for women with this disease are not subtype specific. With the emerg...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0050232
更新日期:2008-12-02 00:00:00
abstract:BACKGROUND:Childhood obstructive sleep apnea (OSA) is associated with neuropsychological deficits of memory, learning, and executive function. There is no evidence of neuronal brain injury in children with OSA. We hypothesized that childhood OSA is associated with neuropsychological performance dysfunction, and with ne...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030301
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Hospitalisation for adversity-related injury (violent, drug/alcohol-related, or self-inflicted injury) has been described as a "teachable moment", when intervention may reduce risks of further harm. Which adolescents are likely to benefit most from intervention strongly depends on their long-term risks of ha...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001931
更新日期:2015-12-29 00:00:00
abstract:BACKGROUND:There is growing concern that racial and ethnic minority communities around the world are experiencing a disproportionate burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19). We investigated racial and ethnic disparities in patterns of COVI...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003379
更新日期:2020-09-22 00:00:00
abstract:BACKGROUND:Psychosis is a severe mental condition that is characterized by a loss of contact with reality and is typically associated with hallucinations and delusional beliefs. There are numerous psychiatric conditions that present with psychotic symptoms, most importantly schizophrenia, bipolar affective disorder, an...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030428
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) has been reported to be a risk factor for cardiovascular (CV) disease. Although the apnea-hypopnea index (AHI) is the most commonly used measure of OSA, other less well studied OSA-related variables may be more pathophysiologically relevant and offer better prediction. The objec...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001599
更新日期:2014-02-04 00:00:00
abstract:BACKGROUND:National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002321
更新日期:2017-06-15 00:00:00
abstract:BACKGROUND:Lifetime glycemic exposure and its relationship with age at diagnosis in type 2 diabetes (T2D) are unknown. Pharmacologic glycemic management strategies for young-onset T2D (age at diagnosis <40 years) are poorly defined. We studied how age at diagnosis affects glycemic exposure, glycemic deterioration, and ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003316
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Identifying stage II patients with colorectal cancer (CRC) at higher risk of progression is a clinical priority in order to optimize the advantages of adjuvant chemotherapy while avoiding unnecessary toxicity. Recently, the intensity and the quality of the host immune response in the tumor microenvironment h...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003292
更新日期:2020-09-24 00:00:00
abstract:BACKGROUND:Socioeconomic disparities in infant mortality have persisted for decades in high-income countries and may have become stronger in some populations. Therefore, new understandings of the mechanisms that underlie socioeconomic differences in infant deaths are essential for creating and implementing health initi...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002831
更新日期:2019-06-14 00:00:00
abstract:BACKGROUND:Clinical trials of interventions designed to prevent severe falciparum malaria in children require a clear endpoint. The internationally accepted definition of severe malaria is sensitive, and appropriate for clinical purposes. However, this definition includes individuals with severe nonmalarial disease and...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0040251
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decisio...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1001629
更新日期:2014-03-25 00:00:00
abstract:BACKGROUND:Only about half the studies that have collected information on the relevance of women's height and body mass index to their risk of developing ovarian cancer have published their results, and findings are inconsistent. Here, we bring together the worldwide evidence, published and unpublished, and describe th...
journal_title:PLoS medicine
pub_type: 杂志文章,meta分析
doi:10.1371/journal.pmed.1001200
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Development of noninvasive molecular assays to improve disease diagnosis and patient monitoring is a critical need. In renal transplantation, acute rejection (AR) increases the risk for chronic graft injury and failure. Noninvasive diagnostic assays to improve current late and nonspecific diagnosis of reject...
journal_title:PLoS medicine
pub_type: 杂志文章,多中心研究
doi:10.1371/journal.pmed.1001759
更新日期:2014-11-11 00:00:00
abstract::Kwonjune Seung and colleagues describe the Eugene Bell Foundation's experience of treating MDR-TB in North Korea. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1002062
更新日期:2016-08-02 00:00:00
abstract:BACKGROUND:Skin atrophy is a common manifestation of aging and is frequently accompanied by ulceration and delayed wound healing. With an increasingly aging patient population, management of skin atrophy is becoming a major challenge in the clinic, particularly in light of the fact that there are no effective therapeut...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.0030493
更新日期:2006-12-01 00:00:00
abstract::Nina Finley and co-authors discuss public involvement in planning and reporting medical research. ...
journal_title:PLoS medicine
pub_type: 杂志文章
doi:10.1371/journal.pmed.1003246
更新日期:2020-09-14 00:00:00
abstract:BACKGROUND:Helminth and protozoan infections affect more than 1 billion children globally. Improving water quality, sanitation, handwashing, and nutrition could be more sustainable control strategies for parasite infections than mass drug administration, while providing other quality of life benefits. METHODS AND FIND...
journal_title:PLoS medicine
pub_type: 杂志文章,随机对照试验
doi:10.1371/journal.pmed.1002841
更新日期:2019-06-26 00:00:00
abstract:BACKGROUND:There have been increasing concerns regarding the safety and efficacy of neuroleptics in people with dementia, but there are very few long-term trials to inform clinical practice. The aim of this study was to determine the impact of long-term treatment with neuroleptic agents upon global cognitive decline an...
journal_title:PLoS medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1371/journal.pmed.0050076
更新日期:2008-04-01 00:00:00