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Milton Fund"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The persistent burden of tuberculosis (TB) disease emphasizes the need to identify individuals with TB for treatment and those at a high risk of incident TB for prevention. Targeting interventions toward those at high risk of developing and transmitting TB is a public health priority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to identify characteristics of individuals involved in TB transmission in a community setting, which may guide the prioritization of targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected clinical and sociodemographic data from a cohort of patients with TB in Lima, Peru. We used whole-genome sequencing data to assess the genetic distance between all possible pairs of patients; we considered pairs to be the result of a direct transmission event if they differed by three or fewer SNPs, and we assumed that the first diagnosed patient in a pair was the transmitter and the second was the recipient. We used logistic regression to examine the association between host factors and the likelihood of direct TB transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Analyzing data from 2,518 index patients with TB, we identified 1,447 direct transmission pairs. Regardless of recipient attributes, individuals less than 34\u2009years old, males, and those with a history of incarceration had a higher likelihood of being transmitters in direct transmission pairs. Direct transmission was more likely when both patients were drinkers or smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identifies men, young adults, former prisoners, alcohol consumers, and smokers as priority groups for targeted interventions. Innovative strategies are needed to extend TB screening to social groups such as young adults and prisoners with limited access to routine preventive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202307-1217oc","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T11:34:27Z","timestamp":1709120067000},"page":"222-233","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":18,"title":["Who Transmits Tuberculosis to Whom: A Cross-Sectional Analysis of a Cohort Study in Lima, Peru"],"prefix":"10.1093","volume":"210","author":[{"given":"Letizia","family":"Trevisi","sequence":"first","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith B.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes C.","family":"Becerra","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger I.","family":"Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Socios en Salud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen C.","family":"Contreras","sequence":"additional","affiliation":[{"name":"Socios en Salud, Lima, Peru"},{"name":"Harvard Global Health Institute, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome T.","family":"Galea","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Socios en Salud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Lecca","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Socios en Salud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa M.","family":"Yataco","sequence":"additional","affiliation":[{"name":"Socios en Salud, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena","family":"Tovar","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zibiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan B.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Global Health Equity, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. 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