title: The transmission of Mycobacterium tuberculosis in high burden settings.
abstract: Unacceptable levels of Mycobacterium tuberculosis transmission are noted in high burden settings and a renewed focus on reducing person-to-person transmission in these communities is needed. We review recent developments in the understanding of airborne transmission. We outline approaches to measure transmission in populations and trials and describe the Wells-Riley equation, which is used to estimate transmission risk in indoor spaces. Present research priorities include the identification of effective strategies for tuberculosis infection control, improved understanding of where transmission occurs and the transmissibility of drug-resistant strains, and estimates of the effect of HIV and antiretroviral therapy on transmission dynamics. When research is planned and interventions are designed to interrupt transmission, resource constraints that are common in high burden settings-including shortages of health-care workers-must be considered.
authors: Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; Wellcome Trust Africa Centre for Population Health, Mtubatuba, South Africa, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: t.yates@ucl.ac.uk.
authors: Tom A
authors: TA
authors: Yates
authors: Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Karonga Prevention Study, Chilumba, Malawi.
authors: Palwasha Y
authors: PY
authors: Khan
authors: Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Modelling Group, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK.
authors: Gwenan M
authors: GM
authors: Knight
authors: UCL Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK.
authors: Jonathon G
authors: JG
authors: Taylor
authors: Centre for Clinical Microbiology, University College London, London, UK.
authors: Timothy D
authors: TD
authors: McHugh
authors: Division of Medicine, University College London, London, UK.
authors: Marc
authors: M
authors: Lipman
authors: Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Modelling Group, London School of Hygiene & Tropical Medicine, London, UK.
authors: Richard G
authors: RG
authors: White
authors: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
authors: Ted
authors: T
authors: Cohen
authors: Department of Global Health, Academic Medical Center, Amsterdam, Netherlands; KNCV Tuberculosis Foundation, The Hague, Netherlands.
authors: Frank G
authors: FG
authors: Cobelens
authors: Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
authors: Robin
authors: R
authors: Wood
authors: Tuberculosis Centre, London School of Hygiene & Tropical Medicine, London, UK; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
authors: David A J
authors: DA
authors: Moore
authors: Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; MRC Clinical Trials Unit at University College London, University College London, London, UK.
authors: Ibrahim
authors: I
authors: Abubakar
mesh_terms: D000391:Air Microbiology; D003140:Communicable Disease Control / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious; D006282:Health Personnel; D006801:Humans; D009169:Mycobacterium tuberculosis; D014376:Tuberculosis / Q000635:transmission*