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. 2021 Mar;27(3):835-844.
doi: 10.3201/eid2703.203840.

Population-Based Geospatial and Molecular Epidemiologic Study of Tuberculosis Transmission Dynamics, Botswana, 2012-2016

Nicola M Zetola, Patrick K Moonan, Eleanor Click, John E Oeltmann, Joyce Basotli, Xiao-Jun Wen, Rosanna Boyd, James L Tobias, Alyssa Finlay, Chawangwa Modongo

Population-Based Geospatial and Molecular Epidemiologic Study of Tuberculosis Transmission Dynamics, Botswana, 2012-2016

Nicola M Zetola et al. Emerg Infect Dis. 2021 Mar.

Abstract

Tuberculosis (TB) elimination requires interrupting transmission of Mycobacterium tuberculosis. We used a multidisciplinary approach to describe TB transmission in 2 sociodemographically distinct districts in Botswana (Kopanyo Study). During August 2012-March 2016, all patients who had TB were enrolled, their sputum samples were cultured, and M. tuberculosis isolates were genotyped by using 24-locus mycobacterial interspersed repetitive units-variable number of tandem repeats. Of 5,515 TB patients, 4,331 (79%) were enrolled. Annualized TB incidence varied by geography (range 66-1,140 TB patients/100,000 persons). A total of 1,796 patient isolates had valid genotyping results and residential geocoordinates; 780 (41%) patients were involved in a localized TB transmission event. Residence in areas with a high burden of TB, age <24 years, being a current smoker, and unemployment were factors associated with localized transmission events. Patients with known HIV-positive status had lower odds of being involved in localized transmission.

Keywords: Botswana; Kopanyo study; Mycobacterium tuberculosis; TB; bacteria; geospatial analysis; molecular epidemiology; population-based analysis; respiratory infections; transmission dynamics; tuberculosis; tuberculosis and other mycobacteria.

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Figures

Figure 1
Figure 1
Catchment areas for population-based geospatial and molecular epidemiologic study of tuberculosis transmission dynamics, Botswana, 2012–2016 (Kopanyo Study). The 2 catchment areas are outlined in black. The neighborhoods within the Gaborone district (A–K, enlarged at bottom right) and Ghanzi district (W, DK, KU, and Y) are shown in gray. Inset map shows location of Botswana in Africa.
Figure 2
Figure 2
Flowchart of study enrollment for population-based geospatial and molecular epidemiologic study of TB transmission dynamics, Botswana, 2012–2016. TB, tuberculosis.
Figure 3
Figure 3
Annualized estimated TB incidence with the most probable localized transmission events superimposed, Botswana, 2012–2016. A) Gaborone; B) Ghanzi District. Shown are areas with most probable clusters identified by using spatial scan statistics (discrete Poisson) for 10 major clusters in Gaborone and Ghanzi (black circles). Data are superimposed on the inverse distance weighted map of annualized incidence of TB patients by neighborhood. TB, tuberculosis.
See this image and copyright information in PMC

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