Considerable efforts are being expended to implement """"""""Directly Observed Therapy, Short course"""""""" (DOTS) globally. However, several key assumptions about the basic biology of tuberculosis transmission, upon which this strategy is based, remain unresolved. Results obtained from our current ICIDR project and other work in which we are engaged have lead us to hypothesize that, in the context of a well functioning DOTS based program, 1) relying solely on sputum microscopy (AFB smear) for diagnosis provides a biased underestimate of TB epidemiology, 2) that patients who are AFB smear negative, but culture positive (termed """"""""paucibacillary"""""""") contribute significantly to disease transmission 3) that there are concerning rates of ongoing transmission of drug resistant M. tuberculosis, and 4) insight gained from the availability of the complete genomic sequence of M. tuberculosis can be exploited to provide clinically and epidemiologically relevant understanding of M. tuberculosis population genetics. We now propose to use """"""""state of the art"""""""" molecular epidemiologic techniques to test these hypotheses. These results will have immediate implications for tuberculosis control programs in many tropical countries. In addition, the availability of fully characterized strains from this study will allow us to examine the nature and consequence of genetic diversity within populations of M. tuberculosis and begin to exploit this information for improved genotyping and diagnostic systems.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AI035969-07
Application #
6169772
Study Section
Special Emphasis Panel (ZAI1-GSM-M (M1))
Program Officer
Higgs, Elizabeth S
Project Start
1994-06-01
Project End
2004-08-31
Budget Start
2000-09-01
Budget End
2001-08-31
Support Year
7
Fiscal Year
2000
Total Cost
$286,712
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Bonacci, Robert A; Cruz-Hervert, Luis Pablo; García-García, Lourdes et al. (2013) Impact of cigarette smoking on rates and clinical prognosis of pulmonary tuberculosis in Southern Mexico. J Infect 66:303-12
Jimenez-Corona, M-E; Garcia-Garcia, L; DeRiemer, K et al. (2006) Gender differentials of pulmonary tuberculosis transmission and reactivation in an endemic area. Thorax 61:348-53
Garcia-Sancho F, Ma Cecilia; Garcia-Garcia, Lourdes; Jimenez-Corona, Ma Eugenia et al. (2006) Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children? Int J Epidemiol 35:1447-54
DeRiemer, Kathryn; Garcia-Garcia, Lourdes; Bobadilla-del-Valle, Miriam et al. (2005) Does DOTS work in populations with drug-resistant tuberculosis? Lancet 365:1239-45
Jacobson, Lara M; de Lourdes Garcia-Garcia, Ma; Hernandez-Avila, Juan Eugenio et al. (2005) Changes in the geographical distribution of tuberculosis patients in Veracruz, Mexico, after reinforcement of a tuberculosis control programme. Trop Med Int Health 10:305-11
del Campo-Rodriguez, Lucio Eduardo Martin; Sifuentes-Osornio, Jose (2004) [Opportunistic infections in the acquired inmunodeficiency syndrome: the history in Mexico 20 years after the beginning of the epidemic] Rev Invest Clin 56:169-80
Banaiee, Niaz; Bobadilla-del-Valle, Miriam; Riska, Paul F et al. (2003) Rapid identification and susceptibility testing of Mycobacterium tuberculosis from MGIT cultures with luciferase reporter mycobacteriophages. J Med Microbiol 52:557-61
Kivi, Marten; Liu, Xuemin; Raychaudhuri, Soumya et al. (2002) Determining the genomic locations of repetitive DNA sequences with a whole-genome microarray: IS6110 in Mycobacterium tuberculosis. J Clin Microbiol 40:2192-8
Porco, T C; Small, P M; Blower, S M (2001) Amplification dynamics: predicting the effect of HIV on tuberculosis outbreaks. J Acquir Immune Defic Syndr 28:437-44
Banaiee, N; Bobadilla-Del-Valle, M; Bardarov Jr, S et al. (2001) Luciferase reporter mycobacteriophages for detection, identification, and antibiotic susceptibility testing of Mycobacterium tuberculosis in Mexico. J Clin Microbiol 39:3883-8

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