Tuberculosis transmission in public locations in Tanzania: A novel approach to studying airborne disease transmission.

Hella, Jerry; Morrow, Carl; Mhimbira, Francis; Ginsberg, Samuel; Chitnis, Nakul; Gagneux, Sebastien; Mutayoba, Beatrice; Wood, Robin; Fenner, Lukas (2017). Tuberculosis transmission in public locations in Tanzania: A novel approach to studying airborne disease transmission. Journal of infection, 75(3), pp. 191-197. Elsevier 10.1016/j.jinf.2017.06.009

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OBJECTIVES For tuberculosis (TB) transmission to occur, an uninfected individual must inhale the previously infected breath. Our objective was to identify potential TB transmission hotspots in metropolitan city of Dar es Salaam, Tanzania and to model the annual risk of TB transmission in different locations of public importance. METHODS We collected indoor carbon dioxide (CO2) data from markets, prisons, night clubs, public transportation, religious and social halls, and from schools. Study volunteers recorded social contacts at each of the locations. We then estimated the annual risks of TB transmission using a modified Wells-Riley equation for different locations. RESULTS The annual risks of TB transmission were highest among prison inmates (41.6%) and drivers (20.3%) in public transport. Lower transmission risks were found in central markets (4.8% for traders, but 0.5% for their customers), passengers on public transport (2.4%), public schools (4.0%), nightclubs (1.7%), religious (0.13%), and social halls (0.12%). CONCLUSION For the first time in a country representative of sub-Saharan Africa, we modelled the risk of TB transmission in important public locations by using a novel approach of studying airborne transmission. This approach can guide identification of TB transmission hotspots and targeted interventions to reach WHO's ambitious End TB targets.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Fenner, Lukas


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services








Tanya Karrer

Date Deposited:

05 Sep 2017 14:05

Last Modified:

19 Oct 2017 13:40

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Airborne transmission; CO(2); Tanzania; Transmission; Transmission hotspots; Tuberculosis; Wells-Riley equation




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