Use of geographic and genotyping tools to characterise tuberculosis transmission in Montreal

Int J Tuberc Lung Dis. 2007 Jun;11(6):632-8.


Setting: In Canada, tuberculosis (TB) is increasingly an urban health problem. Montreal is Canada's second-largest city and the second most frequent destination for new immigrants and refugees.

Objectives: To detect spatial aggregation of cases, areas of excess incidence and local 'hot spots' of transmission in Montreal.

Design: We used residential addresses to geocode active TB cases reported on the Island of Montreal in 1996-2000. After a hot spot analysis suggested two areas of overconcentration, we conducted a spatial scan, with census tracts (population 2500-8000) as the primary unit of analysis and stratification by birthplace. We linked these analyses with genotyping of all available Mycobacterium tuberculosis isolates, using IS6110-RFLP and spoligotyping.

Results: We identified four areas of excess incidence among the foreign-born (incidence rate ratios 1.3-4.1, relative to the entire Island) and one such area among the Canadian-born (incidence rate ratio 2.3). There was partial overlap with the two hot spots. Genotyping indicated ongoing transmission among the foreign-born within the largest high-incidence zone. While this zone overlapped the area of high incidence among Canadian-born, genotyping largely excluded transmission between the two groups.

Conclusions: In a city with low overall incidence, spatial and molecular analyses highlighted ongoing local transmission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cluster Analysis
  • DNA, Bacterial / analysis*
  • Emigration and Immigration* / statistics & numerical data
  • Female
  • Genotype
  • Humans
  • Incidence
  • Male
  • Mass Screening* / statistics & numerical data
  • Middle Aged
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / isolation & purification
  • Polymorphism, Restriction Fragment Length*
  • Quebec / epidemiology
  • Residence Characteristics* / statistics & numerical data
  • Retrospective Studies
  • Tuberculosis / epidemiology
  • Tuberculosis / genetics
  • Tuberculosis / microbiology
  • Tuberculosis / transmission*
  • Urban Health* / statistics & numerical data


  • DNA, Bacterial