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Transmission and control of Mycobact...

Rhee, Jeanne Tigerlily.

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Transmission and control of Mycobacterium tuberculosis.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Transmission and control of Mycobacterium tuberculosis./
作者:	Rhee, Jeanne Tigerlily.
面頁冊數:	105 p.
附註:	Advisers: Julie Parsonnet; Peter Small.
Contained By:	Dissertation Abstracts International63-01B.
標題:	Biology, Biostatistics. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3038140
ISBN:	0493519629

Transmission and control of Mycobacterium tuberculosis.
Rhee, Jeanne Tigerlily.

Transmission and control of Mycobacterium tuberculosis. - 105 p.

Advisers: Julie Parsonnet; Peter Small.

Thesis (Ph.D.)--Stanford University, 2002.

This dissertation is composed of three studies addressing transmission and control of tuberculosis. Specifically, it challenges the notion that outcomes of <italic>Mycobacterium tuberculosis</italic> exposure are explained only by host and environmental factors, and evaluates the role of contact investigations in tuberculosis control and elimination.

ISBN: 0493519629Subjects--Topical Terms:

1018416
Biology, Biostatistics.

Transmission and control of Mycobacterium tuberculosis.
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245 1 0 $a Transmission and control of Mycobacterium tuberculosis.
300 $a 105 p.
500 $a Advisers: Julie Parsonnet; Peter Small.
500 $a Source: Dissertation Abstracts International, Volume: 63-01, Section: B, page: 0209.
502 $a Thesis (Ph.D.)--Stanford University, 2002.
520 $a This dissertation is composed of three studies addressing transmission and control of tuberculosis. Specifically, it challenges the notion that outcomes of <italic>Mycobacterium tuberculosis</italic> exposure are explained only by host and environmental factors, and evaluates the role of contact investigations in tuberculosis control and elimination.
520 $a The first study investigated an epidemiologic approach to evaluating transmissibility and virulence of different <italic>M. tuberculosis</italic> strains, which can be classified into three genotypes based on <italic>katG </italic> and <italic>gyrA</italic> mutations. A case-control analysis tested the association between these genotypes and epidemiologically determined measures of infectivity and pathogenicity. No evidence of association was found, but this study demonstrated that an epidemiologic approach in studying bacterial factors in transmission is feasible.
520 $a The second study examined computer-learning models in exploratory analysis of epidemiologic data. A Bayesian network was constructed using patient data, and identified the same risk factors for recently transmitted disease as in previous studies. A probabilistic relational model was then constructed to incorporate strain and contact investigation data, revealing two interesting findings: (1) rifampin-resistant strains were more likely to have decreased fitness while isoniazid-resistant strains had the opposite trend, and (2) infected contacts were less likely to receive treatment for latent tuberculosis infection when cared for by the private versus public sector. These models can generate hypotheses that are increasingly difficult to discern <italic>a priori</italic> because of the growing complexity of data collected by epidemiologic studies. Findings from these models are suggestions and follow-up studies are warranted.
520 $a The final study investigated differences in outcomes of contacts cared for by the private and public sectors. This study found that infected contacts were more likely to be prescribed treatment for latent tuberculosis infection when cared for by the public sector than a private medical provider (OR<sub> MH</sub> = 7.9; 95% CI:7.5,9.4). The overall secondary case rate was 36.1/100,000 person-years. When adjusted for likelihood of recent infection and treatment for latent tuberculosis infection, the rate ratio for private-sector and public-sector contacts was 1.29 (95% CI:0.50,3.33, p = 0.61). Among contacts with a high likelihood of recent infection and treatment for latent tuberculosis infection, the ratio was 4.61 (95% CI:0.84,25.0; p = 0.053). Results of this study suggest better outcomes for contacts cared for by the public health sector.
590 $a School code: 0212.
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650 4 $a Biology, Microbiology. $3 1017734
650 4 $a Health Sciences, Public Health. $3 1017659
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