title: Acquired and Transmitted Multidrug Resistant Tuberculosis: The Role of Social Determinants.
abstract: Although risk factors for multi-drug resistant tuberculosis are known, few studies have differentiated between acquired and transmitted resistance. It is important to identify factors associated with these different mechanisms to optimize control measures. We conducted a prospective cohort study of index TB patients and their household contacts in Lima, Peru to identify risk factors associated with acquired and transmitted resistance, respectively. Patients with higher socioeconomic status (SES) had a 3-fold increased risk of transmitted resistance compared to those with lower SES when acquired resistance served as the baseline. Quality of housing mediated most of the impact of SES.
authors.affiliation: Unit of Public Health, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Odone
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.
authors.forename: Roger
authors.initials: R
authors.lastname: Calderon
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.|Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Mercedes C
authors.initials: MC
authors.lastname: Becerra
authors.affiliation: Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Zibiao
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Contreras
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.
authors.forename: Rosa
authors.initials: R
authors.lastname: Yataco
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.
authors.forename: Jerome
authors.initials: J
authors.lastname: Galea
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.
authors.forename: Leonid
authors.initials: L
authors.lastname: Lecca
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Bonds
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.|Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.|Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Carole D
authors.initials: CD
authors.lastname: Mitnick
authors.affiliation: Partners In Health / Socios En Salud, Boston, Massachusetts, United States of America and Lima, Peru.|Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.|Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Megan B
authors.initials: MB
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru; D012959:Socioeconomic Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*