title: Clinical and molecular epidemiological features of tuberculosis after the 2011 Japan earthquake and tsunami.
abstract: OBJECTIVE
  To investigate clinical characteristics and prognosis in tuberculosis (TB) patients and the transmission dynamics of TB after the 2011 Japan earthquake and tsunami.
  
  
  METHODS
  This was a retrospective observational cohort study. Data were analyzed among 93 pulmonary TB patients (tsunami-affected areas 25, non-tsunami areas 68) hospitalized during March 2011-March 2012 with 1-year follow-up since treatment commencement. Variable number of tandem repeats (VNTR) typing was conducted for 38 TB strains (tsunami-affected areas 21, non-tsunami areas 17).
  
  
  RESULTS
  Patients from tsunami-affected areas were significantly more likely to be refugees (OR 12.8, 95%CI 2.45-67.20), receive oxygenation (OR 5.0, 95%CI 1.68-14.85), and have a unique VNTR (OR 4.6, 95%CI 1.14-18.41). Patients who died within 1 year were significantly more likely to be older (OR 9.8, 95%CI 1.85-180.26), partially dependent or dependent (OR 11.9, 95%CI 4.28-37.62), and to require oxygenation (OR 4.3, 95%CI 1.47-12.89), and had lower serum albumin levels (OR 11.1, 95%CI 2.97-72.32).
  
  
  CONCLUSIONS
  Risk factors for prognosis of TB after the earthquake were associated with advanced age, low serum albumin level, functional status at admission, and oxygen requirement. The VNTR results suggest that most of the cases with pulmonary TB experienced reactivation of latent tuberculous infection, likely due to the impact of the earthquake and tsunami.
authors.affiliation: Miyagi Cardiovascular and Respiratory Center, Kurihara, Miyagi, Japan; Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.affiliation: Department of Microbiology, Miyagi Prefectural Institute of Public Health and Environment, Sendai, Miyagi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hatakeyama
authors.affiliation: Miyagi Cardiovascular and Respiratory Center, Kurihara, Miyagi, Japan.
authors.forename: B
authors.initials: B
authors.lastname: Uchiyama
authors.affiliation: Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Weber
authors.affiliation: Miyagi Cardiovascular and Respiratory Center, Kurihara, Miyagi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Endo
authors.affiliation: Miyagi Cardiovascular and Respiratory Center, Kurihara, Miyagi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hirakata
authors.affiliation: Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kaku
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004190:Disasters; D055866:Earthquakes; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D057192:Tsunamis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology*
chemical_list: D012709:Serum Albumin