Tuberculosis Epidemiologic Studies Consortium (TBESC)
Task Order 7: Use of network analysis methods to characterize
M. tuberculosis transmission patterns among women and other
high-risk populations
Task Order 7 assesses whether network analysis can help uncover
and characterize ongoing transmission patterns among women and other
high risk populations. The purpose of this project is to examine the
use and practicality of social network analysis methods as a tool
for improving the overall success of TB contact investigations. It
is anticipated that these methods will identify women and other
high-risk groups who will benefit most from TB screening services
and treatment of either active disease or latent TB infection (LTBI).
Sites
Contra Costa County, CA, Dekalb County., GA, Downtown Eastside TB
Clinic, Vancouver, BC
Study Objectives
1. Determine feasibility and TB programs' ability to:
- abstract necessary data from case and contract investigation
records
- supplement these data with interviews about places of social
aggregation
- elicit names of contacts from repeatedly-named contacts
- implement and evaluate an MS Access® database for capturing
all necessary data for performing network analysis
- assess whether network analysis using combination of case,
contact, and place data can help uncover and characterize
ongoing transmission
Study Design
Confirmed TB patients and their identified contacts within the
designated TB control jurisdictions (Contra Costa County, Dekalb
County, and Downtown Vancouver) will serve as the source of the
study population. As part of standard TB control practice, each TB
control program participating in this project currently has
procedures in place to perform contact investigations for TB
patients. The prospective observational study design will
simultaneously gather data at three TBESC sites. Data for use in
network analysis will be abstracted from the usual TB case and
contact investigation forms currently in use at the three
participating local TB control programs. Network analysis software
will be used to link together and characterize the abstracted
contact investigation data gathered by each site. It is anticipated
that this analytic method will help prioritize persons who will
benefit from TB screening services and treatment of active disease
or latent TB infection (LTBI).
Study Progress
The study has been completed, data has been analyzed and
presentations have been given at scientific meetings. A manuscript
has been accepted for publication in the Journal of Infectious
Diseases. Final enrollment was 36 cases and 205 contacts in Dekalb
County, GA; 42 cases and 179 contacts in Contra Costa County, CA;
and 9 cases and 76 contacts in Vancouver, BC. An important outcome
of the study was that infrastructure for implementing network
analysis was successfully implemented at 3 local TB control
programs. Use of a brief questionnaire to collect data from cases
and contacts regarding their places of social aggregation was useful
in helping detect associations among cases and contacts that would
have gone unrecognized in the absence of the places data. In several
instances, network analysis connected TB cases earlier than
genotyping data. This was likely due to very long delays (6-12
months) with lab reporting genotyping results back to states, and
then state reporting to programs. "In house" network analysis
empowered local TB controllers to plan their next contact tracing
activities while awaiting genotyping results.
Last Modified: 07/25/2007
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
|