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Foreign-Born Status and Geographic Patterns of Tuberculosis Genotypes in Tarrant County, Texas

Authors

  • Joseph R. Oppong,

    1. University of North Texas
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  • Curtis J. Denton,

    1. University of North Texas
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  • Patrick K. Moonan,

    1. Centers for Disease Control and Prevention, Division of Tuberculosis Elimination; School of Public Health, University of North Texas Health Science Center of Fort Worth
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    • *At the time of this research, P. K. Moonan was an Instructor of  Medicine at the University of North Texas Health Science Center, Texas College of Osteopathic Medicine, Fort Worth.

  • Stephen E. Weis

    1. Department of Medicine, University of North Texas Health Science Center at Fort Worth; Tarrant County Public Health Department, Fort Worth; Bureau of Tuberculosis Elimination, Texas
    2. Department of Health and Human Services, Austin
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Abstract

Regardless of destination, immigrants arrive with health profiles typical of people in their previous surroundings. Thus, immigrants change the epidemiological profile of destination communities, and immigrant neighborhoods may represent islands of infectious disease. Genotyping has emerged as a useful surveillance tool to track the spread of disease at the molecular level. Yet the spatial distribution of infectious disease at the molecular level associated with migration and immigrant neighborhoods has received little attention. Using molecular genotyping to characterize M. tuberculosis isolated from tuberculosis cases, this article analyzes spatial variations of unique molecular M. tuberculosis strains by zip code in Tarrant County, Texas. The results suggest that immigrant neighborhoods have higher rates of unique isolates of tuberculosis (suggestive of remote transmission) compared to neighborhoods occupied by the native-born. Neighborhoods dominated by the native-born have higher rates of clustered isolates (suggestive of recent transmission). Therefore, in addition to being culturally distinct, immigrant neighborhoods may also be pathogenically distinct from surrounding neighborhoods.

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