Tuberculosis from Mycobacterium bovis in Binational Communities
Tuberculosis from Mycobacterium bovis in Binational Communities
This study used routine TB surveillance data from 1994 through 2005. The study protocol was approved by the Institutional Review Boards of San Diego State University and the University of California, San Diego. Demographic and clinical data were obtained from the Tuberculosis Information Management System (TIMS) database maintained by the San Diego County TB Control Program. Since the early 1990s, a TB isolate has been submitted to the county public health laboratory for every reported TB case. All TB isolates from patient specimens were initially identified as M. tuberculosis complex on the basis of the AccuProbe hybridization protection assay (GenProbe, San Diego, CA, USA). Specimens were further identified as either M. bovis or M. tuberculosis on the basis of culture morphologic findings, the results of the niacin strip test, the nitrate reduction test, and the specimens' susceptibility to PZA. Furthermore, all isolates identified as M. bovis from 2004 and 2005 were confirmed to have spoligotypes consistent with M. bovis. Population data for San Diego County were obtained from San Diego Association of Governments' estimates based on census and calculated data.
We conducted a retrospective trend analysis of all culture-positive TB cases in the San Diego County TIMS database from 1994 through 2005 that were confirmed as either M. bovis or M. tuberculosis. We also conducted a detailed retrospective analysis of demographic and clinical variables associated with M. bovis case-patients and deaths during treatment from 2001 through 2005.
Demographic variables from the TIMS database used in the correlates and mortality analyses included sex, age, ethnicity, and country of birth. Clinical variables included: previous history of TB disease, presence or absence of pulmonary disease, presence or absence of multisite disease, presence or absence of acid-fast bacilli (AFB) in sputum smear, presence or absence of pulmonary lesions by chest radiograph, presence or absence of MDR TB, and HIV status.
Methods
Data Sources
This study used routine TB surveillance data from 1994 through 2005. The study protocol was approved by the Institutional Review Boards of San Diego State University and the University of California, San Diego. Demographic and clinical data were obtained from the Tuberculosis Information Management System (TIMS) database maintained by the San Diego County TB Control Program. Since the early 1990s, a TB isolate has been submitted to the county public health laboratory for every reported TB case. All TB isolates from patient specimens were initially identified as M. tuberculosis complex on the basis of the AccuProbe hybridization protection assay (GenProbe, San Diego, CA, USA). Specimens were further identified as either M. bovis or M. tuberculosis on the basis of culture morphologic findings, the results of the niacin strip test, the nitrate reduction test, and the specimens' susceptibility to PZA. Furthermore, all isolates identified as M. bovis from 2004 and 2005 were confirmed to have spoligotypes consistent with M. bovis. Population data for San Diego County were obtained from San Diego Association of Governments' estimates based on census and calculated data.
Study Design
We conducted a retrospective trend analysis of all culture-positive TB cases in the San Diego County TIMS database from 1994 through 2005 that were confirmed as either M. bovis or M. tuberculosis. We also conducted a detailed retrospective analysis of demographic and clinical variables associated with M. bovis case-patients and deaths during treatment from 2001 through 2005.
Demographic variables from the TIMS database used in the correlates and mortality analyses included sex, age, ethnicity, and country of birth. Clinical variables included: previous history of TB disease, presence or absence of pulmonary disease, presence or absence of multisite disease, presence or absence of acid-fast bacilli (AFB) in sputum smear, presence or absence of pulmonary lesions by chest radiograph, presence or absence of MDR TB, and HIV status.
Source...