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BMJ Open. 2015 Jan 21;5(1):e005636. doi: 10.1136/bmjopen-2014-005636.

Effect of study design and setting on tuberculosis clustering estimates using Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR): a systematic review.

Author information

1
Department of Infection and Population Health, University College London, London, UK.
2
Department of Infection and Population Health, University College London, London, UK Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK Clinical Trials Unit, Medical Research Council, London, UK.
3
Division of Global Health Equity, Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, USA.
4
Department of Infection, Centre for Clinical Microbiology, University College London, London, UK.

Abstract

OBJECTIVES:

To systematically review the evidence for the impact of study design and setting on the interpretation of tuberculosis (TB) transmission using clustering derived from Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) strain typing.

DATA SOURCES:

MEDLINE, EMBASE, CINHAL, Web of Science and Scopus were searched for articles published before 21st October 2014.

REVIEW METHODS:

Studies in humans that reported the proportion of clustering of TB isolates by MIRU-VNTR were included in the analysis. Univariable meta-regression analyses were conducted to assess the influence of study design and setting on the proportion of clustering.

RESULTS:

The search identified 27 eligible articles reporting clustering between 0% and 63%. The number of MIRU-VNTR loci typed, requiring consent to type patient isolates (as a proxy for sampling fraction), the TB incidence and the maximum cluster size explained 14%, 14%, 27% and 48% of between-study variation, respectively, and had a significant association with the proportion of clustering.

CONCLUSIONS:

Although MIRU-VNTR typing is being adopted worldwide there is a paucity of data on how study design and setting may influence estimates of clustering. We have highlighted study design variables for consideration in the design and interpretation of future studies.

KEYWORDS:

EPIDEMIOLOGY; MOLECULAR BIOLOGY

PMID:
25609667
PMCID:
PMC4305070
DOI:
10.1136/bmjopen-2014-005636
[Indexed for MEDLINE]
Free PMC Article

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