Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana

Résumé fourni par la source

T uberculosis (TB) remains among the leading causes of death from infectious diseases worldwide, killing 1.5 million persons in 2020 despite being preventable and curable (1).High-burden TB countries often contend with limited financial and labor resources and rely on generalized interventions that, although helpful, treat TB as a uniform epidemic (2-4).However, recent advances in molecular methods have shown that TB epidemics are composed of multiple simultaneous chains of transmission that could serve as distinct targets for intervention (4-7).Targeted interventions to interrupt transmission might be particularly effective for reducing TB in high-burden settings, where recent infections contribute substantially to disease incidence (3-6).Genomic sequencing is a powerful tool for identifying discrete, but closely related, Mycobacterium tuberculosis strains, helping to reconstruct likely chains of recent transmission (3,8,9).Genomic and geospatial data can be integrated to investigate whether transmission chains fall within distinct geographic areas (3-6).For example, spatial clusters of closely related M. tuberculosis strains may indicate localized areas of ongoing transmission, which could be targeted for public health interventions, such as active case finding (3-5,10).A growing body of evidence suggests that geographically targeted interventions could be effective and cost-efficient in high-burden, low-resource settings and instrumental in accelerating progress toward eliminating TB (4,11-13).