Molecular epidemiology of tuberculosis in the Netherlands: A nationwide study from 1993 through 1997

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Abstract

To disclose risk factors for active tuberculosis transmission in the Netherlands, restriction fragment length polymorphism (RFLP) patterns of 78% of the Mycobacterium tuberculosis isolates, from the period 1993-1997, were analyzed. Of the respective 4266 cases, 46% were found in clusters of isolates with identical RFLPs, and 35% were attributed to active transmission. The clustering percentage increased strongly with the number of isolates; taking this into account, fewer cases were clustered than has been reported in other studies. Contact investigations in the five largest clusters of 23-47 patients suggested epidemiological linkage between cases. Of patients identified through contact tracing, 91% were clustered. Demographic risk factors for active transmission of tuberculosis included male sex, urban residence, Dutch and Surinamese nationality, and long-term residence in the Netherlands. Human immunodeficiency virus infection was not an independent risk factor for active transmission. Isoniazid-resistant strains were relatively less frequently clustered, suggesting that these generated fewer secondary cases.

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Van Soolingen, D., Borgdorff, M. W., De Haas, P. E. W., Sebek, M. M. G. G., Veen, J., Dessens, M., … Van Embden, J. D. A. (1999). Molecular epidemiology of tuberculosis in the Netherlands: A nationwide study from 1993 through 1997. Journal of Infectious Diseases, 180(3), 726–736. https://doi.org/10.1086/314930

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