Molecular epidemiology and mapping of tuberculosis in Israel: do migrants transmit the disease to locals?

Goldblatt, Drora; Rorman, Efrat; Chemtob, Daniel; Pj, Freidlin; Cedar, Noa; Kaidar-Shwartz, Hasia; Dveyrin, Zeev; Mor, Z

doi:10.5588/ijtld.14.0186

Cited by 15 publications

(18 citation statements)

References 28 publications

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“…Few linked data are available for incident tuberculosis after migration to low-incidence countries in populations screened before entry, and even fewer data are available for risk factors for subsequent development of disease in this screened population. Investigators in previous studies focused on prevalent cases detected during pre-entry screening, 6 used national tuberculosis notification data alone with no linkage to pre-entry screening records, 7 or followed up a selected cohort of individuals from a few countries or subnationally after arrival 8, 9, 10. Thus, the most effective approach to reduction of the disease burden in migrants from high-incidence to low-incidence countries—including latent tuberculosis screening and treatment, active case finding, and improvement of health-care access—is uncertain.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland

et al. 2016

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SummaryBackgroundTuberculosis elimination in countries with a low incidence of the disease necessitates multiple interventions, including innovations in migrant screening. We examined a cohort of migrants screened for tuberculosis before entry to England, Wales, and Northern Ireland and tracked the development of disease in this group after arrival.MethodsAs part of a pilot pre-entry screening programme for tuberculosis in 15 countries with a high incidence of the disease, the International Organization for Migration screened all applicants for UK visas aged 11 years or older who intended to stay for more than 6 months. Applicants underwent a chest radiograph, and any with results suggestive of tuberculosis underwent sputum testing and culture testing (when available). We tracked the development of tuberculosis in those who tested negative for the disease and subsequently migrated to England, Wales, and Northern Ireland with the Enhanced Tuberculosis Surveillance system. Primary outcomes were cases of all forms of tuberculosis (including clinically diagnosed cases), and bacteriologically confirmed pulmonary tuberculosis.FindingsOur study cohort was 519 955 migrants who were screened for tuberculosis before entry to the UK between Jan 1, 2006, and Dec 31, 2012. Cases notified on the Enhanced Tuberculosis Surveillance system between Jan 1, 2006, and Dec 31, 2013, were included. 1873 incident cases of all forms of tuberculosis were identified, and, on the basis of data for England, Wales, and Northern Ireland, the estimated incidence of all forms of tuberculosis in migrants screened before entry was 147 per 100 000 person-years (95% CI 140–154). The estimated incidence of bacteriologically confirmed pulmonary tuberculosis in migrants screened before entry was 49 per 100 000 person-years (95% CI 45–53). Migrants whose chest radiographs were compatible with active tuberculosis but with negative pre-entry microbiological results were at increased risk of tuberculosis compared with those with no radiographic abnormalities (incidence rate ratio 3·2, 95% CI 2·8–3·7; p<0·0001). Incidence of tuberculosis after migration increased significantly with increasing WHO-estimated prevalence of tuberculosis in migrants' countries of origin. 35 of 318 983 pre-entry screened migrants included in a secondary analysis with typing data were assumed index cases. Estimates of the rate of assumed reactivation tuberculosis ranged from 46 (95% CI 42–52) to 91 (82–102) per 100 000 population.InterpretationMigrants from countries with a high incidence of tuberculosis screened before being granted entry to low-incidence countries pose a negligible risk of onward transmission but are at increased risk of tuberculosis, which could potentially be prevented through identification and treatment of latent infection in close collaboration with a pre-entry screening programme.FundingWellcome Trust, UK National Institute for Health Research, UK Medical Research Council, Public Health England, and Department of Health Policy Research Programme.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland

et al. 2016

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“…Further, molecular epidemiological studies have been instrumental to define recent transmission dynamics in various settings as well as to describe the local and global population structure of the MTBC [13]. Modern molecular DNA fingerprinting methods like Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeats (MIRU-VNTRs) typing and spacer oligonucleotide typing (spoligotyping) are highly suited to investigate both, the population structure and transmission of the MTBC in communities or special settings such as prisons [14]. …”

Section: Introductionmentioning

confidence: 99%

Drug resistance and population structure of M.tuberculosis isolates from prisons and communities in Ethiopia

et al. 2016

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BackgroundThe population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown.MethodsA comparative cross sectional study was conducted on 126 MTBC strains isolated from prisons and communities in southwestern, southern and eastern Ethiopia. Phenotypic drug susceptibility testing was performed with the MGIT960 system. Combined 24-loci Mycobacterium interspersed repetitive unit-variable number tandem repeat and spacer oligonucleotide typing methods were used to study the MTBC population structure. The obtained data from prisons and communities were compared using statistical tests and regression analysis.ResultsA diverse population structure with 11 different lineages and sub-lineages was identified. The predominant strains were the recently described Ethiopia_H37Rv like (27.52%) and Ethiopia_3 (16.51%) with equal lineage distribution between prisons and communities. 28.57% of prison strains and 31.82% of community strains shared the identical genotype with at least one other strain. The multidrug-resistance (MDR) prevalence of the community was 2.27% whereas that of prisons was 9.52%. The highest mono resistance was seen against streptomycin (15.89%).ConclusionTuberculosis in communities and prisons is caused by a variety of MTBC lineages with predominance of local Ethiopian lineages. The increasing prevalence of MDR MTBC strains is alarming. These findings suggest the need for new approaches for control of MDR tuberculosis in Ethiopia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2041-x) contains supplementary material, which is available to authorized users.

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“…One study in Denmark actually estimated that infection of a migrant by a native Dane was up to 2.5 times more frequent than vice versa (448). The percentage of all clusters that consist of both natives and immigrants has also been used as a measure of transmission permeability; this amounted to 24% of all clusters in San Francisco (449); 29% in Almeria, Spain (450); 34% in Barcelona, Spain (451); and 36% in a recent study in Israel (452). The difference in transmission permeability between settings is well illustrated by a study in the Eastern Province of Saudi Arabia, where 25/33 (76%) clusters of 532 culture-confirmed TB cases occurring in a 2-year period were mixed autochthonous/ immigrant clusters (453).…”

Section: Applications Of Strain Typing To M Tuberculosis Complex Isomentioning

confidence: 99%

Methodological and Clinical Aspects of the Molecular Epidemiology of Mycobacterium tuberculosis and Other Mycobacteria

et al. 2016

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SUMMARYMolecular typing has revolutionized epidemiological studies of infectious diseases, including those of a mycobacterial etiology. With the advent of fingerprinting techniques, many traditional concepts regarding transmission, infectivity, or pathogenicity of mycobacterial bacilli have been revisited, and their conventional interpretations have been challenged. Since the mid-1990s, when the first typing methods were introduced, a plethora of other modalities have been proposed. So-called molecular epidemiology has become an essential subdiscipline of modern mycobacteriology. It serves as a resource for understanding the key issues in the epidemiology of tuberculosis and other mycobacterial diseases. Among these issues are disclosing sources of infection, quantifying recent transmission, identifying transmission links, discerning reinfection from relapse, tracking the geographic distribution and clonal expansion of specific strains, and exploring the genetic mechanisms underlying specific phenotypic traits, including virulence, organ tropism, transmissibility, or drug resistance. Since genotyping continues to unravel the biology of mycobacteria, it offers enormous promise in the fight against and prevention of the diseases caused by these pathogens. In this review, molecular typing methods forMycobacterium tuberculosisand nontuberculous mycobacteria elaborated over the last 2 decades are summarized. The relevance of these methods to the epidemiological investigation, diagnosis, evolution, and control of mycobacterial diseases is discussed.

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Molecular epidemiology and mapping of tuberculosis in Israel: do migrants transmit the disease to locals?

Abstract: Predominant M. tuberculosis genotypes in Israel in 2008-2010 were similar to genotypes endemic to the migrants' countries of origin. Epidemiological investigations did not demonstrate transmission between migrants and Israeli-born patients sharing the same cluster.

Cited by 15 publications

References 28 publications

Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland

Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland

Drug resistance and population structure of M.tuberculosis isolates from prisons and communities in Ethiopia

Methodological and Clinical Aspects of the Molecular Epidemiology of Mycobacterium tuberculosis and Other Mycobacteria

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