Browsing by Author "White RG"

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    Comparison of indoor contact time data in Zambia and Western Cape, South Africa suggests targeting of interventions to reduce Mycobacterium tuberculosis transmission should be informed by local data.
    (2016-Feb-09) McCreesh N; Looker C; Dodd PJ; Plumb ID; Shanaube K; Muyoyeta M; Godfrey-Faussett P; Corbett EL; Ayles H; White RG; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. clare_looker@hotmail.com.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. faussettp@unaids.org.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. Monde.Muyoyeta@cidrz.org.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. idplumb@gmail.com.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. helen@zambart.org.zm.; Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK. p.j.dodd@sheffield.ac.uk.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. p.j.dodd@sheffield.ac.uk.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. lizcorbett04@gmail.com.; HIV and TB Theme, Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi. lizcorbett04@gmail.com.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. richard.white@lshtm.ac.uk.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. nicky.mccreesh@lshtm.ac.uk.; TB Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. Monde.Muyoyeta@cidrz.org.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. kshanaube@zambart.org.zm.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. helen@zambart.org.zm.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: In high incidence settings, the majority of Mycobacterium tuberculosis (M.tb) transmission occurs outside the household. Little is known about where people's indoor contacts occur outside the household, and how this differs between different settings. We estimate the number of contact hours that occur between adults and adult/youths and children in different building types in urban areas in Western Cape, South Africa, and Zambia. METHODS: Data were collected from 3206 adults using a cross-sectional survey, on buildings visited in a 24-h period, including building function, visit duration, and number of adults/youths and children (5-12 years) present. The mean numbers of contact hours per day by building function were calculated. RESULTS: Adults in Western Cape were more likely to visit workplaces, and less likely to visit shops and churches than adults in Zambia. Adults in Western Cape spent longer per visit in other homes and workplaces than adults in Zambia. More adults/youths were present at visits to shops and churches in Western Cape than in Zambia, and fewer at homes and hairdressers. More children were present at visits to shops in Western Cape than in Zambia, and fewer at schools and hairdressers. Overall numbers of adult/youth indoor contact hours were the same at both sites (35.4 and 37.6 h in Western Cape and Zambia respectively, p = 0.4). Child contact hours were higher in Zambia (16.0 vs 13.7 h, p = 0.03). Adult/youth and child contact hours were highest in workplaces in Western Cape and churches in Zambia. Compared to Zambia, adult contact hours in Western Cape were higher in workplaces (15.2 vs 8.0 h, p = 0.004), and lower in churches (3.7 vs 8.6 h, p = 0.002). Child contact hours were higher in other peoples' homes (2.8 vs 1.6 h, p = 0.03) and workplaces (4.9 vs 2.1 h, p = 0.003), and lower in churches (2.5 vs 6.2, p = 0.004) and schools (0.4 vs 1.5, p = 0.01). CONCLUSIONS: Patterns of indoor contact between adults and adults/youths and children differ between different sites in high M.tb incidence areas. Targeting public buildings with interventions to reduce M.tb transmission (e.g. increasing ventilation or UV irradiation) should be informed by local data.
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    Coverage of clinic-based TB screening in South Africa may be low in key risk groups.
    (2016-Mar-21) McCreesh N; Faghmous I; Looker C; Dodd PJ; Plumb ID; Shanaube K; Muyoyeta M; Godfrey-Faussett P; Ayles H; White RG; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine (LSHTM), London, UK.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia ; TB Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Clinical Research, LSHTM, London, UK.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia ; Department of Clinical Research, LSHTM, London, UK.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine (LSHTM), London, UK ; Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    The South African Ministry of Health has proposed screening all clinic attendees for tuberculosis (TB). Amongst other factors, male sex and bar attendance are associated with higher TB risk. We show that 45% of adults surveyed in Western Cape attended a clinic within 6 months, and therefore potentially a relatively high proportion of the population could be reached through clinic-based screening. However, fewer than 20% of all men aged 18-25 years, or men aged 26-45 who attend bars, attended a clinic. The population-level impact of clinic-based screening may be reduced by low coverage among key risk groups.