Patterson Benjamin, Hermans Sabine, Wood Robin, Cobelens Frank
Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
Centre for Tropical and Travel Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
Sci Rep. 2025 Jul 2;15(1):22687. doi: 10.1038/s41598-024-81558-w.
Recent studies using sensitive aerosol sampling and detection methodologies, have enumerated aerosolized Mycobacterium tuberculosis (Mtb) across a spectrum of tuberculosis states in a high-burdened setting. To estimate the Mtb exposure rate we used a Bayesian inference approach to fit a reversible catalytic model to age-specific, respiratory bioaerosol Mtb prevalence data. Longitudinal monitoring of symptomatic sputum-negative, untreated clinic attendees informed a prior for the Mtb bioaerosol clearance rate. Based on an observed bioaerosol Mtb population prevalence of 62.6% and a clearance half-life of 83 days, the estimated exposure rate was 5.1/year. This result was extremely sensitive to bioaerosol Mtb population prevalence but including a simulated rate of exposure of zero until the age of 10-years did not influence the overall estimate for rate of exposure. A catalytic model without reversion was a poorer fit to the prevalence data than the primary reverse catalytic model. Mtb bioaerosol sampling findings imply an extremely high rate of Mtb exposure within tuberculosis endemic communities with rapid cycling between bioaerosol carriage and clearance. Even assuming a much lower bioaerosol Mtb population prevalence, the estimated exposure rate is an order of magnitude greater than published annual rates of Mtb infection.
最近使用灵敏的气溶胶采样和检测方法进行的研究，在高负担环境中对一系列结核病状态下的雾化结核分枝杆菌（Mtb）进行了计数。为了估计Mtb暴露率，我们采用贝叶斯推理方法，将一个可逆催化模型拟合到特定年龄的呼吸道生物气溶胶Mtb流行率数据。对有症状的痰涂片阴性、未经治疗的门诊患者进行纵向监测，为Mtb生物气溶胶清除率提供了一个先验值。基于观察到的生物气溶胶Mtb群体流行率为62.6%以及清除半衰期为83天，估计的暴露率为每年5.1次。该结果对生物气溶胶Mtb群体流行率极为敏感，但纳入10岁之前模拟的零暴露率并未影响总体暴露率估计。与主要的反向催化模型相比，无反向的催化模型对流行率数据的拟合较差。Mtb生物气溶胶采样结果表明，在结核病流行社区内，Mtb暴露率极高，生物气溶胶携带和清除之间循环迅速。即使假设生物气溶胶Mtb群体流行率低得多，估计的暴露率仍比已公布的Mtb年感染率高一个数量级。
