Renardy Marissa E, Gillen Craig, Yang Zhenhua, Mukasa Leonard, Bates Joseph, Butler Russ, Kirschner Denise E
Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America.
Department of Biology, AdventHealth University, Orlando, FL, United States of America.
PLOS Glob Public Health. 2023 Feb 23;3(2):e0001580. doi: 10.1371/journal.pgph.0001580. eCollection 2023.
Tuberculosis (TB) elimination in the United States remains elusive, and community-specific, localized intervention strategies may be necessary to meet elimination goals. A better understanding of the genotypic diversity of Mtb, the population subgroups affected by different TB strains, and differences in disease presentation associated with these strains can aid in identifying risk groups and designing tailored interventions. We analyze TB incidence and genotype data from all Arkansas counties over an 11-year time span from 2010 through 2020. We use statistical methods and geographic information systems (GIS) to identify demographic and disease phenotypic characteristics that are associated with different Mtb genetic lineages in the study area. We found the following variables to be significantly associated with genetic lineage (p<0.05): patient county, patient birth country, patient ethnicity, race, IGRA result, disease site, chest X-ray result, whether or not a case was identified as part of a cluster, patient age, occupation risk, and date arrived in the US. Different Mtb lineages affect different subpopulations in Arkansas. Lineage 4 (EuroAmerican) and Lineage 2 (East Asian) are most prevalent, although the spatial distributions differ substantially, and lineage 2 (East Asian) is more frequently associated with case clusters. The Marshallese remain a particularly high-risk group for TB in Arkansas.
在美国，消除结核病仍然难以实现，可能需要采取针对特定社区的局部干预策略来实现消除目标。更好地了解结核分枝杆菌的基因型多样性、受不同结核菌株影响的人群亚组以及与这些菌株相关的疾病表现差异，有助于识别风险群体并设计针对性的干预措施。我们分析了2010年至2020年这11年间阿肯色州所有县的结核病发病率和基因型数据。我们使用统计方法和地理信息系统（GIS）来识别研究区域内与不同结核分枝杆菌基因谱系相关的人口统计学和疾病表型特征。我们发现以下变量与基因谱系显著相关（p<0.05）：患者所在县、患者出生国家、患者种族、族裔、IGRA检测结果、疾病部位、胸部X光检查结果、病例是否被认定为聚集性病例的一部分、患者年龄、职业风险以及抵达美国的日期。不同的结核分枝杆菌谱系影响着阿肯色州的不同亚人群。谱系4（欧美裔）和谱系2（东亚裔）最为常见，尽管其空间分布差异很大，并且谱系2（东亚裔）更常与病例聚集相关。马绍尔群岛人在阿肯色州仍然是结核病的一个特别高危群体。
