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2786960420180209202203161080-60592332017MarEmerging infectious diseasesEmerg Infect DisMolecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana.487490487-49010.3201/eid2303.161183During 2012-2015, 10 of 24 patients infected with matching genotypes of Mycobacterium tuberculosis received care at the same hospital in Gaborone, Botswana. Nosocomial transmission was initially suspected, but we discovered plausible sites of community transmission for 20 (95%) of 21 interviewed patients. Active case-finding at these sites could halt ongoing transmission.SurieDiyaDFaneOthusitseOFinlayAlyssaAOgopotseMatsiriMTobiasJames LJLClickEleanor SESModongoChawangwaCZetolaNicola MNMMoonanPatrick KPKOeltmannJohn EJEKopanyo Study GroupengR01 AI097045AINIAID NIH HHSUnited StatesPEPFARPEPFARJournal ArticleResearch Support, U.S. Gov't, Non-P.H.S.Research Support, N.I.H., Extramural20170315United StatesEmerg Infect Dis95081551080-6040IMAdolescentAdultBotswanaepidemiologyCluster AnalysisCommunity-Acquired InfectionsepidemiologymicrobiologytransmissionDisease OutbreaksFemaleGenotypeHumansMaleMiddle AgedMolecular EpidemiologyMycobacterium tuberculosisgeneticsisolation & purificationTuberculosisepidemiologymicrobiologytransmissionYoung AdultAfricaBotswanaGISGaboroneMycobacterium tuberculosisTBbacteriaclustercommunity transmissionepidemiologygenotypinggeographic information systemmappingnosocomial transmissionoutbreaktransmissiontransmission dynamicstuberculosistuberculosis and other mycobacteria20161122602018210602016112260201731ppublish27869604PMC538272510.3201/eid2303.161183Frieden TR, Sterling TR, Munsiff SS, Watt CJ, Dye C. Tuberculosis. Lancet. 2003;362:887–99. 10.1016/S0140-6736(03)14333-410.1016/S0140-6736(03)14333-413678977Horsburgh CR Jr. Priorities for the treatment of latent tuberculosis infection in the United States. N Engl J Med. 2004;350:2060–7. 10.1056/NEJMsa03166710.1056/NEJMsa03166715141044Yuen CM, Amanullah F, Dharmadhikari A, Nardell EA, Seddon JA, Vasilyeva I, et al. Turning off the tap: stopping tuberculosis transmission through active case-finding and prompt effective treatment. Lancet. 2015;386:2334–43. 10.1016/S0140-6736(15)00322-010.1016/S0140-6736(15)00322-0PMC713806526515675Stop TB. Partnership. The Global Plan to End TB 2016–2020 [cited 2016 Jan 20]. http://www.stoptb.org/global/plan/plan2/National Tuberculosis Controllers Association; Centers for Disease Control and Prevention (CDC). Guidelines for the investigation of contacts of persons with infectious tuberculosis. Recommendations from the National Tuberculosis Controllers Association and CDC. MMWR Recomm Rep. 2005;54(No. RR-15):1–47.16357823Barnes PF, Cave MD. Molecular epidemiology of tuberculosis. N Engl J Med. 2003;349:1149–56. 10.1056/NEJMra02196410.1056/NEJMra02196413679530World Health Organization. Global tuberculosis report 2015. Geneva: the Organization; 2015.Zetola NM, Modongo C, Moonan PK, Click E, Oeltmann JE, Shepherd J, et al. Tuberculosis and multidrug-resistant tuberculosis transmission dynamics among communities with high HIV prevalence: the Botswana Kopanyo Study. BMJ Open. 2016;6:e010046. 10.1136/bmjopen-2015-01004610.1136/bmjopen-2015-010046PMC487411127160840Supply P, Allix C, Lesjean S, Cardoso-Oelemann M, Rüsch-Gerdes S, Willery E, et al. Proposal for standardization of optimized mycobacterial interspersed repetitive unit-variable-number tandem repeat typing of Mycobacterium tuberculosis. J Clin Microbiol. 2006;44:4498–510. 10.1128/JCM.01392-0610.1128/JCM.01392-06PMC169843117005759Wallgren A. The time-table of tuberculosis. Tubercle. 1948;29:245–51. 10.1016/S0041-3879(48)80033-410.1016/S0041-3879(48)80033-418101320Chamie G, Wandera B, Marquez C, Kato-Maeda M, Kamya MR, Havlir DV, et al. Identifying locations of recent TB transmission in rural Uganda: a multidisciplinary approach. Trop Med Int Health. 2015;20:537–45. 10.1111/tmi.1245910.1111/tmi.12459PMC435518125583212Verver S, Warren RM, Munch Z, Richardson M, van der Spuy GD, Borgdorff MW, et al. Proportion of tuberculosis transmission that takes place in households in a high-incidence area. Lancet. 2004;363:212–4. 10.1016/S0140-6736(03)15332-910.1016/S0140-6736(03)15332-914738796trying2...