AUTHOR=Winglee Kathryn , McDaniel Clinton J. , Linde Lauren , Kammerer Steve , Cilnis Martin , Raz Kala M. , Noboa Wendy , Knorr Jillian , Cowan Lauren , Reynolds Sue , Posey James , Sullivan Meissner Jeanne , Poonja Shameer , Shaw Tambi , Talarico Sarah , Silk Benjamin J. TITLE=Logically Inferred Tuberculosis Transmission (LITT): A Data Integration Algorithm to Rank Potential Source Cases JOURNAL=Frontiers in Public Health VOLUME=9 YEAR=2021 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.667337 DOI=10.3389/fpubh.2021.667337 ISSN=2296-2565 ABSTRACT=
Understanding tuberculosis (TB) transmission chains can help public health staff target their resources to prevent further transmission, but currently there are few tools to automate this process. We have developed the Logically Inferred Tuberculosis Transmission (LITT) algorithm to systematize the integration and analysis of whole-genome sequencing, clinical, and epidemiological data. Based on the work typically performed by hand during a cluster investigation, LITT identifies and ranks potential source cases for each case in a TB cluster. We evaluated LITT using a diverse dataset of 534 cases in 56 clusters (size range: 2–69 cases), which were investigated locally in three different U.S. jurisdictions. Investigators and LITT agreed on the most likely source case for 145 (80%) of 181 cases. By reviewing discrepancies, we found that many of the remaining differences resulted from errors in the dataset used for the LITT algorithm. In addition, we developed a graphical user interface, user's manual, and training resources to improve LITT accessibility for frontline staff. While LITT cannot replace thorough field investigation, the algorithm can help investigators systematically analyze and interpret complex data over the course of a TB cluster investigation.