Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 18 citations
PubMed: 34752730 DOI: 10.1164/rccm.202102-0405OC
Molecular Detection of Airborne in South African High Schools.
Am J Respir Crit Care Med 205(3):350-356
Authors: Erick W Bunyasi, Keren Middelkoop, Anastasia Koch, Zeenat Hoosen, Humphrey Mulenga, Angelique K K Luabeya, Justin Shenje, Simon C Mendelsohn, Michele Tameris, Thomas J Scriba, Digby F Warner, Robin Wood, Jason R Andrews, Mark Hatherill
Affiliations
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine.
- Department of Pathology.
- Desmond Tutu HIV Centre.
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, Institute of Infectious Disease and Molecular Medicine, and.
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), University of Cape Town, Cape Town, South Africa; and.
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California.
Abstract
South African adolescents carry a high tuberculosis disease burden. It is not known if schools are high-risk settings for (MTB) transmission. To detect airborne MTB genomic DNA in classrooms. We studied 72 classrooms occupied by 2,262 students in two South African schools. High-volume air filtration was performed for median 40 (interquartile range [IQR], 35-54) minutes and assayed by droplet digital PCR (ddPCR)-targeting MTB region of difference 9 (RD9), with concurrent CO concentration measurement. Classroom data were benchmarked against public health clinics. Students who consented to individual tuberculosis screening completed a questionnaire and sputum collection (Xpert MTB/RIF Ultra) if symptom positive. Poisson statistics were used for MTB RD9 copy quantification. ddPCR assays were positive in 13/72 (18.1%) classrooms and 4/39 (10.3%) clinic measurements ( = 0.276). Median ambient CO concentration was 886 (IQR, 747-1223) ppm in classrooms versus 490 (IQR, 405-587) ppm in clinics ( < 0.001). Average airborne concentration of MTB RD9 was 3.61 copies per 180,000 liters in classrooms versus 1.74 copies per 180,000 liters in clinics ( = 0.280). Across all classrooms, the average risk of an occupant inhaling one MTB RD9 copy was estimated as 0.71% during one standard lesson of 35 minutes. Among 1,836/2,262 (81.2%) students who consented to screening, 21/90 (23.3%) symptomatic students produced a sputum sample, of which one was Xpert MTB/RIF Ultra positive. Airborne MTB genomic DNA was detected frequently in high school classrooms. Instantaneous risk of classroom exposure was similar to the risk in public health clinics.
MeSH
Research Design, Respiratory Tract Diseases, Critical Care, Schools, Public Health, Air, Sputum, Adolescent, Tuberculosis
Cited by
- Transmission in High-Incidence Settings-New Paradigms and Insights. Pathogens, 2022
- Care for adolescents with drug-susceptible pulmonary tuberculosis in Lima, Peru: a qualitative assessment. BMJ Open, 2025
- SARS-CoV-2 transmission with and without mask wearing or air cleaners in schools in Switzerland: A modeling study of epidemiological, environmental, and molecular data. PLoS Med, 2023
- Tuberculosis: First in Flight. Am J Respir Crit Care Med, 2022
- Dataset of indoor air parameter measurements relating to indoor air quality and thermal comfort in South African primary school classrooms of various building infrastructure types. Data Brief, 2024
- Reimagining the status quo: How close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine, 2022
- Infection prevention and control measures during the COVID-19 pandemic and airborne tuberculosis transmission during primary care visits in South Africa. Int J Infect Dis, 2025
- Factors driving adolescent tuberculosis incidence by age and sex in 30 high-tuberculosis burden countries: a mathematical modelling study. BMJ Glob Health, 2025