Unravelling the thread of transmission : pairing traditional epidemiology with genomics to understand tuberculosis transmission dynamics
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Guthrie, Jennifer L.
issued: 2021-06-30T07:00:00Z
issued: 2018
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: In Canada, TB remains a public health concern, with the disease becoming increasingly entrenched in our most vulnerable populations. In 2012, British Columbia (BC) prepared a strategic plan with the aim of reducing incidence in the province by 50% over 10 years. A key aspect of this is preventing person-to-person spread of TB within BC—challenging, as our understanding of endemic transmission is incomplete. The objective of this dissertation is to use new advances in technology, including whole genome sequencing (WGS), to address the knowledge gaps around who, where, and how transmission occurs in BC and provide the foundation upon which new TB prevention policies and programs will be developed. Methods: This dissertation draws on data routinely collected from persons diagnosed with culture-confirmed TB in BC (2005–2014) and linked to laboratory data from their corresponding Mycobacterium tuberculosis (Mtb) isolate(s). Collaborations with Yukon and Ontario provided additional data. 24-locus MIRU-VNTR genotype results were available for each Mtb isolate across all three study populations. WGS of genotypically clustered BC isolates and all Yukon isolates was carried out and the data analyzed using a bioinformatics pipeline developed at Oxford University. Descriptive and inferential statistics were used to examine clinical and demographic characteristics of persons with Mtb isolates belonging to a cluster according to genotyping and WGS methods. Results: Universal genotyping of all Mtb isolates collected in BC over a ten-year period revealed that 57.6% of the study population had a genotypically unique Mtb isolate. Sixteen large genotype clusters were identified, nine in predominately Canadian-born (CB) persons. Application of WGS indicated the large genotypic clusters comprised of mainly non-Canadian-born (nCB) persons did not represent recent, endemic transmission within BC, and WGS additionally refined many of the CB clusters to smaller sub-clusters. The…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/68146
note: Unravelling the Thread of Transmission: Pairing Traditional Epidemiology with Genomics to Understand Tuberculosis Transmission Dynamics by Jennifer L. Guthrie B.Sc. (Honours), Brock University, 2000 M.Sc. (Distinction), Brock University, 2003 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) December 2018 © Jennifer L. Guthrie, 2018 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Unravelling the Thread of Transmission: Pairing Traditional Epidemiology with Genomics to Understand Tuberculosis Transmission Dynamics submitted by Jennifer L. Guthrie in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Population and Public Health Examining Committee: Dr. Jennifer Gardy, School of Population and Public Health Supervisor Dr. James Johnston, TB Services Evaluation Lead, BC Centre for Disease Control Supervisory Committee Member Dr. Bonnie Henry, BC Provincial Health Officer Supervisory Committee Member Dr. Martin Hirst, Microbiology and Immunology University Examiner Dr. Richard Harrigan, Experimental Medicine University Examiner Additional Supervisory Committee Members: Dr. Lindsay Eltis, Microbiology & Immunology Supervisory Committee Member Supervisory Committee Member iii Abstract Background: In Canada, TB remains a public health concern, with the disease becoming increasingly entrenched in our most vulnerable populations. In 2012, British Columbia (BC) prepared a strategic plan with the aim of reducing incidence in the province by 50% over 10 years. A key aspect of this is preventing person-to-person spread of TB within BC—challenging, as our understanding of endemic transmission is incomplete. The objective of this dissertation is to use new…
has type: Thesis/Dissertation
date issued: 2019-02
is shown at: 10.14288/1.0375825
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/68146