Molecular epidemiology of Mycobacterium tuberculosis in an urban area in Japan, 2002-2006.
METHODS
Shinjuku City, Tokyo, Japan.


OBJECTIVE
To evaluate the status of transmission of Mycobacterium tuberculosis in Shinjuku City to allocate resources efficiently and effectively for a successful tuberculosis (TB) control programme.


METHODS
Observational descriptive study combining the genotype data of M. tuberculosis with TB patient profiles.


RESULTS
The genotype clustering rate was significantly higher in males (adjusted odds ratio [aOR] 1.94, 95%CI 1.04-3.65, P = 0.038), patients aged <40 years (aOR 2.09, 95%CI 1.17-3.71, P = 0.012) and the homeless (aOR 2.72, 95%CI 1.42-5.20, P = 0.002), and was lower for the foreign-born (aOR 0.21, 95%CI 0.06-0.76, P = 0.017). Among 45 genotype clusters containing 152 TB patients, 26 clusters containing 102 patients (67.1%) were composed of a mix of homeless and non-homeless patients. One of the mixed clusters included an 8-month-old infant born in Japan.


CONCLUSIONS
The study revealed that M. tuberculosis transmission occurred more frequently among the homeless than in non-homeless persons. However, transmission by casual contact between the homeless and the general population was also shown to occur.
Ohkado
A
A
Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Japan. ohkadoa@jata.or.jp
Nagamine
M
M
Murase
Y
Y
Uchimura
K
K
Kaguraoka
S
S
Tatsumi
Y
Y
Yamada
N
N
Ohmori
M
M
Maeda
S
S
Maeda
H
H
Kato
S
S
Mori
T
T
Ishikawa
N
N
D000328:Adult; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D005260:Female; D015276:Health Care Rationing; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D014505:Urban Population