Geo-epidemiologic and molecular characterization to identify social, cultural, and economic factors where targeted tuberculosis control activities can reduce incidence in Maryland, 2004-2010.

Objectives: Tuberculosis (TB) disproportionately affects members of socioeconomically disadvantaged and minority populations in the U.S. We describe the geospatial distribution of TB cases in Maryland, identify areas at high risk for TB, and compare the geospatial clustering of cases with genotype clustering and demographic, socioeconomic, and TB risk-factor information.

Tuberculosis control in a large urban jail: discordance between policy and reality.

Objective: This study evaluated adherence to tuberculosis control guidelines, published by the Centers for Disease Control and Prevention in 1996, in a large urban jail. Jails are a critical locale because of high risk for tuberculosis transmission in a congregate setting.

Methods: Symptom screening at intake into the facility was systematically observed.

Improved adherence and less toxicity with rifampin vs isoniazid for treatment of latent tuberculosis: a retrospective study.

Background: Treatment of latent tuberculosis infection (LTBI) is an important aspect of tuberculosis control in the United States, but the effectiveness of this strategy is compromised by poor adherence to the recommended 9-month isoniazid regimen. In this study, we compared treatment completion and clinically recognized adverse drug reactions in patients prescribed 9 months of isoniazid therapy or 4 months of rifampin therapy for LTBI.

Methods: Retrospective chart review of patients who received LTBI treatment at a public health clinic.

Molecular epidemiology of pleural and other extrapulmonary tuberculosis: a Maryland state review.

Background: Limited information exists about the current epidemiological characteristics of extrapulmonary tuberculosis. However, pleural tuberculosis is usually considered to be a manifestation of primary tuberculosis. Our objective was to use molecular epidemiological techniques to describe the occurrence of pleural and other extrapulmonary tuberculosis in Maryland, a state with moderate tuberculosis incidence.

Molecular epidemiology of tuberculosis in a low- to moderate-incidence state: are contact investigations enough?

To assess the circumstances of recent transmission of tuberculosis (TB) (progression to active disease <2 years after infection), we obtained DNA fingerprints for 1172 (99%) of 1179 Mycobacterium tuberculosis isolates collected from Maryland TB patients from 1996 to 2000. We also reviewed medical records and interviewed patients with genetically matching M. tuberculosis strains to identify epidemiologic links (cluster investigation).

Cross-jurisdictional transmission of Mycobacterium tuberculosis in Maryland and Washington, D C, 1996-2000, linked to the homeless.

From 1996 to 2000, 23 Maryland and Washington, D.C., tuberculosis cases were identified in one six-band DNA cluster.