Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May 9;6(5):e010046.
doi: 10.1136/bmjopen-2015-010046.

Protocol for a population-based molecular epidemiology study of tuberculosis transmission in a high HIV-burden setting: the Botswana Kopanyo study

N M Zetola  1 , C Modongo  2 , P K Moonan  3 , E Click  3 , J E Oeltmann  3 , J Shepherd  4 , A Finlay  3
Affiliations

Protocol for a population-based molecular epidemiology study of tuberculosis transmission in a high HIV-burden setting: the Botswana Kopanyo study

N M Zetola et al. BMJ Open. .

Abstract

Introduction: Mycobacterium tuberculosis (Mtb) is transmitted from person to person via airborne droplet nuclei. At the community level, Mtb transmission depends on the exposure venue, infectiousness of the tuberculosis (TB) index case and the susceptibility of the index case's social network. People living with HIV infection are at high risk of TB, yet the factors associated with TB transmission within communities with high rates of TB and HIV are largely undocumented. The primary aim of the Kopanyo study is to better understand the demographic, clinical, social and geospatial factors associated with TB and multidrug-resistant TB transmission in 2 communities in Botswana, a country where 60% of all patients with TB are also infected with HIV. This manuscript describes the methods used in the Kopanyo study.

Methods and analysis: The study will be conducted in greater Gaborone, which has high rates of HIV and a mobile population; and in Ghanzi, a rural community with lower prevalence of HIV infection and home to the native San population. Kopanyo aims to enrol all persons diagnosed with TB during a 4-year study period. From each participant, sputum will be cultured, and for all Mtb isolates, molecular genotyping (24-locus mycobacterial interspersed repetitive units-variable number of tandem repeats) will be performed. Patients with matching genotype results will be considered members of a genotype cluster, a proxy for recent transmission. Demographic, behavioural, clinical and social information will be collected by interview. Participant residence, work place, healthcare facilities visited and social gathering venues will be geocoded. We will assess relationships between these factors and cluster involvement to better plan interventions for reducing TB transmission.

Ethics: Ethical approval from the Independent Review Boards at the University of Pennsylvania, US Centers for Disease Control and Prevention, Botswana Ministry of Health and University of Botswana has been obtained.

Keywords: Molecular Epidemiology; Multi-Drug Resistant Tuberculosis; Transmission.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Districts and cities selected for this tuberculosis transmission study.
Figure 2
Figure 2
Overview of the study procedures and data collection. GPS, Global Positioning System; TB, tuberculosis.
Figure 3
Figure 3
Simplified algorithm for participant identification, enrolment and study procedures. TB, tuberculosis.
See this image and copyright information in PMC

References

    1. Kamerbeek J, Schouls L, Kolk A et al. . Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology. J Clin Microbiol 1997;35:907–14. - PMC - PubMed
    1. World Health Organization. Global tuberculosis control: surveillance, planning, financing. Geneva: World Health Organization, 2014. http://www.who.int/tb/publications/global_report/en/
    1. World Health Organization. TB/HIV fact sheet 2009. Geneva: World Health Organization, 2009. http://www.who.int/tb/challenges/hiv/factsheet_hivtb_2009.pdf
    1. World Health Organization. Interim policy on collaborative TB/HIV activities. Geneva: World Health Organization, 2004; WHO/HTM/TB/2004.330. http://www.who.int/hiv/pub/tb/tbhiv/en/index.html
    1. Roeger LI, Feng Z, Castillo-Chavez C. Modeling TB and HIV co-infections. Math Biosci Eng 2009;6:815–37. 10.3934/mbe.2009.6.815 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources