Giuseppe
Emeritus
Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case?control study and recommendations (Euro Surveill., abstract, edited)
[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 16, Issue 13, 31 March 2011
Surveillance and outbreak reports
Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case?control study and recommendations
H Maguire 1,2, S Brailsford 1, J Carless 1, M Yates 3, L Altass 4, S Yates 5, S Anaraki 6, A Charlett 7, S Lozewicz 8, M Lipman 9, G Bothamley 10
1. Health Protection Agency, London Region Epidemiology Unit, London, United Kingdom
2. St George?s Hospital Medical School, London, United Kingdom
3. Health Protection Agency Mycobacterium Reference Unit, Barts and the London School of Medicine and Dentistry, London, United Kingdom
4. North Central London TB Network, Haringey Teaching Primary Care Trust and National Health Service London, London, United Kingdom
5. Her Majesty?s Prison Pentonville, London, United Kingdom
6. Health Protection Agency, North East and Central Health Protection Unit, London, United Kingdom
7. Health Protection Agency, Centre for Infections, London, United Kingdom
8. North Middlesex University Hospital, London, United Kingdom
9. Royal Free University Hospital, London, United Kingdom
10. Homerton University Hospital, London, United Kingdom
Citation style for this article: Maguire H, Brailsford S, Carless J, Yates M, Altass L, Yates S, Anaraki S, Charlett A, Lozewicz S, Lipman M, Bothamley G. Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case?control study and recommendations. Euro Surveill. 2011;16(13)
ii=19830. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830
Date of submission: 14 November 2010
We conducted a case?control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear- positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7?3.4) and of white (OR: 2.9; 95% CI: 1.8?4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7?20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7?60.6), unemployed (OR: 4.1; 95% CI: 3.0?5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4?1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.
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[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 16, Issue 13, 31 March 2011
Surveillance and outbreak reports
Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case?control study and recommendations
H Maguire 1,2, S Brailsford 1, J Carless 1, M Yates 3, L Altass 4, S Yates 5, S Anaraki 6, A Charlett 7, S Lozewicz 8, M Lipman 9, G Bothamley 10
1. Health Protection Agency, London Region Epidemiology Unit, London, United Kingdom
2. St George?s Hospital Medical School, London, United Kingdom
3. Health Protection Agency Mycobacterium Reference Unit, Barts and the London School of Medicine and Dentistry, London, United Kingdom
4. North Central London TB Network, Haringey Teaching Primary Care Trust and National Health Service London, London, United Kingdom
5. Her Majesty?s Prison Pentonville, London, United Kingdom
6. Health Protection Agency, North East and Central Health Protection Unit, London, United Kingdom
7. Health Protection Agency, Centre for Infections, London, United Kingdom
8. North Middlesex University Hospital, London, United Kingdom
9. Royal Free University Hospital, London, United Kingdom
10. Homerton University Hospital, London, United Kingdom
Citation style for this article: Maguire H, Brailsford S, Carless J, Yates M, Altass L, Yates S, Anaraki S, Charlett A, Lozewicz S, Lipman M, Bothamley G. Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case?control study and recommendations. Euro Surveill. 2011;16(13)
ii=19830. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19830Date of submission: 14 November 2010
We conducted a case?control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear- positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7?3.4) and of white (OR: 2.9; 95% CI: 1.8?4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7?20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7?60.6), unemployed (OR: 4.1; 95% CI: 3.0?5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4?1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.
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