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Reducing TB hotspots effective at reducing overall transmission rate
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Controlling the spread of tuberculosis in geographic areas with high tuberculosis rates could greatly reduce transmission rates in the overall population, according to a recently published study.
David Dowdy, MD, PhD, and colleagues from the Bloomberg School of Public Health at Johns Hopkins University examined surveillance data taken from Rio de Janeiro, Brazil, where researchers noted that overall TB rates were reduced by 9.8% over 5 years. The researchers created mathematical models to examine the link between hotspot transmission and the community as a whole, and they took into account coinfection with HIV.
Dowdy and colleagues concluded that TB rates throughout the city were reduced by a mean of 2% yearly when hotspot transmission was reduced, resulting in a 29.7% reduction over 50 years. The hotspots saw a 62.8% reduction; citywide, there was a 23.1% decrease.
“Targeting treatment of ‘core groups’ as a way to reduce community-wide transmission is common with diseases like HIV and malaria, but is less accepted as a mantra for TB control,” Dowdy said in a press release about the study. “Our findings suggest that hotspots containing 6% of a city’s population can be responsible for 35% or more of its ongoing TB transmission. Controlling TB in these hotspots may have a similar impact on long-term, community-wide TB incidence as achieving the same targets in the remaining 94% of the population. … The ‘35/6’ rule seen in our study suggests that targeting hotspots is still the best way to control TB in a community.”
Disclosures: The research was funded by the Bill & Melinda Gates Foundation. Dr. Dowdy reports no relevant financial disclosures.
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