1. Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL): A cross-sectional observational study protocol using respondent driven sampling.
- Author
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Carney T, Rooney JA, Niemand N, Myers B, Theron D, Wood R, White LF, Meade CS, Chegou NN, Ragan E, Walzl G, Horsburgh R, Warren RM, and Jacobson KR
- Subjects
- Adolescent, Adult, Contact Tracing, Cross-Sectional Studies, DNA, Bacterial chemistry, DNA, Bacterial metabolism, Diphenhydramine administration & dosage, Diphenhydramine urine, Drug Combinations, Female, Humans, Male, Methamphetamine administration & dosage, Methamphetamine urine, Methaqualone administration & dosage, Methaqualone urine, Mycobacterium tuberculosis genetics, Mycobacterium tuberculosis isolation & purification, Reagent Kits, Diagnostic, Registries, South Africa, Sputum microbiology, Surveys and Questionnaires, Tuberculosis diagnosis, Young Adult, Drug Users statistics & numerical data, Tuberculosis transmission
- Abstract
People who use illicit drugs (PWUDs) have been identified as a key at-risk group for tuberculosis (TB). Examination of illicit drug use networks has potential to assess the risk of TB exposure and disease progression. Research also is needed to assess mechanisms for accelerated TB transmission in this population. This study aims to 1) assess the rate of TB exposure, risk of disease progression, and disease burden among PWUD; 2) estimate the proportion of active TB cases resulting from recent transmission within this network; and 3) evaluate whether PWUD with TB disease have physiologic characteristics associated with more efficient TB transmission. Our cross-sectional, observational study aims to assess TB transmission through illicit drug use networks, focusing on methamphetamine and Mandrax (methaqualone) use, in a high TB burden setting and identify mechanisms underlying accelerated transmission. We will recruit and enroll 750 PWUD (living with and without HIV) through respondent driven sampling in Worcester, South Africa. Drug use will be measured through self-report and biological measures, with sputum specimens collected to identify TB disease by Xpert Ultra (Cepheid) and mycobacterial culture. We will co-enroll those with microbiologic evidence of TB disease in Aim 2 for molecular and social network study. Whole genome sequencing of Mycobacteria tuberculosis (Mtb) specimens and social contact surveys will be done for those diagnosed with TB. For Aim 3, aerosolized Mtb will be compared in individuals with newly diagnosed TB who do and do not smoke illicit drug. Knowledge from this study will provide the basis for a strategy to interrupt TB transmission in PWUD and provide insight into how this fuels overall community transmission. Results have potential for informing interventions to reduce TB spread applicable to high TB and HIV burden settings. Trial registration: Clinicaltrials.gov Registration Number: NCT041515602. Date of Registration: 5 November 2019., Competing Interests: The authors declare that they have no competing interests.
- Published
- 2022
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