title: High Tuberculosis Strain Diversity Among New York City Public Housing Residents.
abstract: OBJECTIVE
  We sought to better understand tuberculosis (TB) epidemiology among New York City Housing Authority (NYCHA) residents, after a recent TB investigation identified patients who had the same TB strain.
  
  
  METHODS
  The study population included all New York City patients with TB confirmed during 2001 through 2009. Patient address at diagnosis determined NYCHA residence. We calculated TB incidence, reviewed TB strain data, and identified factors associated with TB clustering.
  
  
  RESULTS
  During 2001 to 2009, of 8953 individuals in New York City with TB, 512 (6%) had a NYCHA address. Among the US-born, TB incidence among NYCHA residents (6.0/100,000 persons) was twice that among non-NYCHA residents (3.0/100,000 persons). Patients in NYCHA had high TB strain diversity. US birth, younger age, and substance use were associated with TB clustering among NYCHA individuals with TB.
  
  
  CONCLUSIONS
  High TB strain diversity among residents of NYCHA with TB does not suggest transmission among residents. These findings illustrate that NYCHA's higher TB incidence is likely attributable to its higher concentration of individuals with known TB risk factors.
authors.affiliation: All authors are with the New York City Department of Health and Mental Hygiene Bureau of Tuberculosis Control, Queens, NY. Patrick Dawson is also with Columbia University Mailman School of Public Health Department of Epidemiology, New York, NY.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dawson
authors.affiliation: All authors are with the New York City Department of Health and Mental Hygiene Bureau of Tuberculosis Control, Queens, NY. Patrick Dawson is also with Columbia University Mailman School of Public Health Department of Epidemiology, New York, NY.
authors.forename: Bianca R
authors.initials: BR
authors.lastname: Perri
authors.affiliation: All authors are with the New York City Department of Health and Mental Hygiene Bureau of Tuberculosis Control, Queens, NY. Patrick Dawson is also with Columbia University Mailman School of Public Health Department of Epidemiology, New York, NY.
authors.forename: Shama D
authors.initials: SD
authors.lastname: Ahuja
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016000:Cluster Analysis; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011638:Public Housing; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders; D014376:Tuberculosis / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics*; D055815:Young Adult