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Estimating the effective reproductive rate of M. Tuberculosis from changes in molecular clustering rates, to measure the impact of public health interventions on TB transmission (INTERRUPT TB)

The major aim of the present proposal is to understand whether ECF has the ability to reduce transmission of TB in the intervention group when compared to the control group. To achieve this, the following objectives are defined:
Compare the proportion of TB-due-to-recent-transmission in intervention and control arms of a Cluster Randomized Trial on the impact of Enhanced Case Finding
a) Genotype isolates from intervention and control groups, using state-of-the-art molecular techniques (Spoligotype analysis, 24-locus MIRU-VNTR, and whole genome sequencing)
b) Compare genetic diversity among isolates, shown to be clustered by spoligotype and MIRU-VNTR- analysis, using Genome Sequences.
c) Compare the genetic clustering rate between isolates from each of the study groups, adjusted for the TB case notification rate.Model the change in the effective reproductive rate of M. tuberculosis resulting from the Enhanced Case Finding intervention
a) Identify host-, pathogen- and environmental factors associated with genotypically clustered transmission chains, including geographical clustering and identifiable epidemiological links.
b) Simulate the effect of ECF on the incidence of TB-due-to-recent-transmission and model the effective reproductive numbers (RE).
c) Determine the number of TB cases and -deaths averted among HIV-infected and uninfected people by implementation of ECF.
Date:1 Jan 2013  →  31 Jul 2018