{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:49:59Z","timestamp":1776048599288,"version":"3.50.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Institute of Allergy and Infectious Diseases at the National Institutes of Health"},{"name":"Centers for Excellence in Translational Research","award":["U01 AI057786"],"award-info":[{"award-number":["U01 AI057786"]}]},{"name":"Centers for Excellence in Translational Research","award":["U19 AI076217"],"award-info":[{"award-number":["U19 AI076217"]}]},{"name":"Centers for Excellence in Translational Research","award":["U19 AI109755"],"award-info":[{"award-number":["U19 AI109755"]}]},{"name":"Tuberculosis Research Units program","award":["U19 AI111224"],"award-info":[{"award-number":["U19 AI111224"]}]},{"name":"Beat-TB project","award":["U19 AI142793"],"award-info":[{"award-number":["U19 AI142793"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Household-based studies are commonly used to investigate tuberculosis (TB) transmission and evaluate preventive interventions. These studies typically assume that household contacts (HHCs) who develop TB disease were infected by the identified index patient. However, community-acquired infections may challenge this assumption, potentially biasing findings. Here, we evaluated the proportion of genetically linked index\u2013HHC pairs and examined whether this proportion varied based on the TB burden in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study in Lima, Peru, enrolling microbiologically confirmed pulmonary TB index patients and their HHCs who were followed for 1 year. Mycobacterium tuberculosis (Mtb) isolates from culture-positive index patients and HHCs underwent whole-genome sequencing (WGS). We defined index\u2013HHC patient pairs as resulting from within-household transmission when the genetic distance between their Mtb isolates was \u226412 single nucleotide polymorphisms. To contextualize our findings, we conducted a systematic review of Mtb genotyping studies that used spoligotyping, restriction fragment length polymorphisms , mycobacterial interspersed repetitive units\u2013variable number tandem repeats, or WGS to assess within-household TB infection transmission among index\u2013HHC patient pairs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our Lima study, among 175 index\u2013HHC patient pairs, 109 (62%) were classified as within-household transmission. The systematic review identified 22 qualifying studies from settings with TB burdens ranging from 6.7 to 845 cases per 100\u2009000 person-years. Studies in settings with TB incidence of \u2264250 per 100\u2009000 person-years consistently reported linkage proportions of \u226561%, whereas high-burden settings exhibited greater variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that, among individuals exposed to TB at home, within-household transmission predominates in moderate- or low-TB-burden settings. However, its relative contribution in high-incidence settings remains unclear.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyag042","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:18:13Z","timestamp":1773404293000},"source":"Crossref","is-referenced-by-count":0,"title":["Quantifying within-household tuberculosis transmission: a systematic review and prospective cohort study"],"prefix":"10.1093","volume":"55","author":[{"given":"Chuan-Chin","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women\u2019s Hospital , Boston, MA,","place":["United States"]},{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia E","family":"Madden","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes C","family":"Becerra","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Calderon","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Humana, Universidad de San Mart\u00edn de Porres , Lima,","place":["Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-127X","authenticated-orcid":false,"given":"Alexander L","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women\u2019s Hospital , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Contreras","sequence":"additional","affiliation":[{"name":"Partners In Health\u2014Socios En Salud Sucursal Peru , Lima,","place":["Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7633-8401","authenticated-orcid":false,"given":"Judith","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Partners In Health\u2014Socios En Salud Sucursal Peru , Lima,","place":["Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1363-3985","authenticated-orcid":false,"given":"Leonid","family":"Lecca","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]},{"name":"Partners In Health\u2014Socios En Salud Sucursal Peru , Lima,","place":["Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Yataco","sequence":"additional","affiliation":[{"name":"Partners In Health\u2014Socios En Salud Sucursal Peru , Lima,","place":["Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zibiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women\u2019s Hospital , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Jauregui","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA,","place":["United States"]},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health , New York, NY,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan B","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Department of Medicine, Brigham and Women\u2019s Hospital , Boston, MA,","place":["United States"]},{"name":"Department of Global Health and Social Medicine, Harvard Medical School , Boston, MA,","place":["United States"]},{"name":"Department of Epidemiology, Harvard T.H. 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