by N. Sarita Shah, Sara C. Auld, James C.M. Brust et al.
N Engl J Med 2017;376:243-53, January 19, 2017
11 pp. 682 kB
South Africa has one of the highest burdens of tuberculosis and drug-resistant tuberculosis in the world. In the past decade, the number of cases of XDR tuberculosis has increased by a factor of 10, to more than 1500 cases in 2012.12 Compounding the tuberculosis epidemic is the concurrent epidemic of HIV infection; rates of coinfection exceed 70%, and rates of long-term survival among patients with XDR tuberculosis and HIV infection are less than 20%. In this study, the authors sought to quantify the role of transmission and to elucidate how and where transmission is occurring. They combined traditional epidemiologic tools with social-network, geospatial, and genotyping methods to describe population-level transmission of XDR tuberculosis.