Neighborhood socioeconomic position and tuberculosis transmission: A retrospective cohort study

Eyal Oren, Masahiro Narita, Charles Nolan, Jonathan Mayer

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Current understanding of tuberculosis (TB) genotype clustering in the US is based on individual risk factors. This study sought to identify whether area-based socioeconomic status (SES) was associated with genotypic clustering among culture-confirmed TB cases.Methods: A retrospective cohort analysis was performed on data collected on persons with incident TB in King County, Washington, 2004-2008. Multilevel models were used to identify the relationship between area-level SES at the block group level and clustering utilizing a socioeconomic position index (SEP).Results: Of 519 patients with a known genotyping result and block group, 212 (41%) of isolates clustered genotypically. Analyses suggested an association between lower area-based SES and increased recent TB transmission, particularly among US-born populations. Models in which community characteristics were measured at the block group level demonstrated that lower area-based SEP was positively associated with genotypic clustering after controlling for individual covariates. However, the trend in higher clustering odds with lower SEP index quartile diminished when additional block-group covariates.Conclusions: Results stress the need for TB control interventions that take area-based measures into account, with particular focus on poor neighborhoods. Interventions based on area-based characteristics, such as improving case finding strategies, utilizing location-based screening and addressing social inequalities, could reduce recent rates of transmission.

Original languageEnglish (US)
Article number227
JournalBMC Infectious Diseases
Issue number1
StatePublished - Apr 27 2014


  • Genotyping
  • Infectious disease transmission
  • Molecular epidemiology
  • Multilevel
  • Socioeconomic status
  • Tuberculosis

ASJC Scopus subject areas

  • Infectious Diseases


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