{"id":"https://openalex.org/W7204248309","doi":"https://doi.org/10.1136/bmjopen-2025-111823","title":"Spatial clustering and transmission networks of multidrug-resistant tuberculosis in Rwanda: a national retrospective genomic and spatial epidemiological study","display_name":"Spatial clustering and transmission networks of multidrug-resistant tuberculosis in Rwanda: a national retrospective genomic and spatial epidemiological study","publication_year":2026,"publication_date":"2026-08-01","ids":{"openalex":"https://openalex.org/W7204248309","doi":"https://doi.org/10.1136/bmjopen-2025-111823","pmid":"https://pubmed.ncbi.nlm.nih.gov/42648769","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13536106"},"language":"en","primary_location":{"id":"doi:10.1136/bmjopen-2025-111823","doi":"https://doi.org/10.1136/bmjopen-2025-111823","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjopen-2025-111823","pdf_url":null,"source":{"id":"https://openalex.org/S79054089","display_name":"BMJ Open","issn_l":"2044-6055","issn":["2044-6055"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Open","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1136/bmjopen-2025-111823","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5051405805","display_name":"Isabel Cuella Martin","orcid":"https://orcid.org/0000-0001-7543-3386","observed_orcids":["https://orcid.org/0000-0001-7543-3386"]},"institutions":[{"id":"https://openalex.org/I149213910","display_name":"University of Antwerp","ror":"https://ror.org/008x57b05","country_code":"BE","type":"education","lineage":["https://openalex.org/I149213910"]},{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":true,"raw_author_name":"Isabel Cuella-Martin","raw_affiliation_strings":["Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium","Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":"https://orcid.org/0000-0001-7543-3386","affiliations":[{"raw_affiliation_string":"Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium","institution_ids":["https://openalex.org/I149213910"]},{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020254453","display_name":"Fran\u00e7ois Hakizayezu","orcid":"https://orcid.org/0009-0000-4265-2371","observed_orcids":["https://orcid.org/0009-0000-4265-2371"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Francois Hakizayezu","raw_affiliation_strings":["National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079105567","display_name":"Wim Mulders","orcid":"https://orcid.org/0000-0002-9566-3653","observed_orcids":["https://orcid.org/0000-0002-9566-3653"]},"institutions":[{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Wim Mulders","raw_affiliation_strings":["Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067327845","display_name":"Hosee Niyompano","orcid":"https://orcid.org/0000-0002-7611-5678","observed_orcids":["https://orcid.org/0000-0002-7611-5678"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Hosee Niyompano","raw_affiliation_strings":["National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5106452160","display_name":"Docteur Runyambo","orcid":"https://orcid.org/0009-0006-6103-6703","observed_orcids":["https://orcid.org/0009-0006-6103-6703"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Docteur Runyambo","raw_affiliation_strings":["National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Reference Laboratory Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036989798","display_name":"Jelle Keysers","orcid":"https://orcid.org/0009-0000-4685-7972","observed_orcids":["https://orcid.org/0009-0000-4685-7972"]},"institutions":[{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Jelle Keysers","raw_affiliation_strings":["Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045845191","display_name":"Willem Bram de Rijk","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Willem B De Rijk","raw_affiliation_strings":["Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5069490240","display_name":"Yves Mucyo Habimana","orcid":"https://orcid.org/0000-0001-6097-1405","observed_orcids":["https://orcid.org/0000-0001-6097-1405"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Yves Habimana Mucyo","raw_affiliation_strings":["Tuberculosis and Other Respiratory Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":"https://orcid.org/0000-0001-6097-1405","affiliations":[{"raw_affiliation_string":"Tuberculosis and Other Respiratory Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5055461864","display_name":"Patrick Migambi","orcid":"https://orcid.org/0000-0003-4344-2872","observed_orcids":["https://orcid.org/0000-0003-4344-2872"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Patrick Migambi","raw_affiliation_strings":["Tuberculosis and Other Respiratory Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Tuberculosis and Other Respiratory Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038756960","display_name":"Claude Mambo Muvunyi","orcid":"https://orcid.org/0000-0003-4180-442X","observed_orcids":["https://orcid.org/0000-0003-4180-442X"]},"institutions":[{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Claude Mambo Muvunyi","raw_affiliation_strings":["Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049174092","display_name":"Conor Joseph Meehan","orcid":"https://orcid.org/0000-0003-0724-8343","observed_orcids":["https://orcid.org/0000-0003-0724-8343"]},"institutions":[{"id":"https://openalex.org/I52590639","display_name":"Nottingham Trent University","ror":"https://ror.org/04xyxjd90","country_code":"GB","type":"education","lineage":["https://openalex.org/I52590639"]},{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE","GB"],"is_corresponding":false,"raw_author_name":"Conor J Meehan","raw_affiliation_strings":["Nottingham Trent University, Nottingham, UK","Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nottingham Trent University, Nottingham, UK","institution_ids":["https://openalex.org/I52590639"]},{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044411310","display_name":"Bouke Catherine de Jong","orcid":"https://orcid.org/0000-0002-1017-4675","observed_orcids":["https://orcid.org/0000-0002-1017-4675"]},"institutions":[{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Bouke C de Jong","raw_affiliation_strings":["Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033438385","display_name":"Leen Rigouts","orcid":"https://orcid.org/0000-0003-3301-9480","observed_orcids":["https://orcid.org/0000-0003-3301-9480"]},"institutions":[{"id":"https://openalex.org/I149213910","display_name":"University of Antwerp","ror":"https://ror.org/008x57b05","country_code":"BE","type":"education","lineage":["https://openalex.org/I149213910"]},{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Leen Rigouts","raw_affiliation_strings":["Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium","Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium","institution_ids":["https://openalex.org/I149213910"]},{"raw_affiliation_string":"Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084505437","display_name":"Jean Claude Semuto Ngabonziza","orcid":"https://orcid.org/0000-0002-6075-5603","observed_orcids":["https://orcid.org/0000-0002-6075-5603"]},"institutions":[{"id":"https://openalex.org/I4210087849","display_name":"University of Rwanda","ror":"https://ror.org/00286hs46","country_code":"RW","type":"education","lineage":["https://openalex.org/I4210087849"]},{"id":"https://openalex.org/I4210148345","display_name":"Rwanda Biomedical Center","ror":"https://ror.org/03jggqf79","country_code":"RW","type":"healthcare","lineage":["https://openalex.org/I4210148345","https://openalex.org/I4210165170"]}],"countries":["RW"],"is_corresponding":false,"raw_author_name":"Jean Claude Semuto Ngabonziza","raw_affiliation_strings":["Department of Clinical Biology, University of Rwanda, Kigali, Rwanda","Research Innovation and Data Science Division, Rwanda Biomedical Center, Kigali, Rwanda"],"raw_orcid":"https://orcid.org/0000-0002-6075-5603","affiliations":[{"raw_affiliation_string":"Department of Clinical Biology, University of Rwanda, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210087849"]},{"raw_affiliation_string":"Research Innovation and Data Science Division, Rwanda Biomedical Center, Kigali, Rwanda","institution_ids":["https://openalex.org/I4210148345"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5001198483","display_name":"Ellen M.H. Mitchell","orcid":"https://orcid.org/0000-0002-2824-3499","observed_orcids":["https://orcid.org/0000-0002-2824-3499"]},"institutions":[{"id":"https://openalex.org/I78281549","display_name":"Instituut voor Tropische Geneeskunde","ror":"https://ror.org/03xq4x896","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I78281549"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Ellen Mitchell","raw_affiliation_strings":["Unit of Mycobacterial Diseases and Neglected Tropical Disease, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium"],"raw_orcid":"https://orcid.org/0000-0002-2824-3499","affiliations":[{"raw_affiliation_string":"Unit of Mycobacterial Diseases and Neglected Tropical Disease, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium","institution_ids":["https://openalex.org/I78281549"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5051405805"],"corresponding_institution_ids":["https://openalex.org/I149213910","https://openalex.org/I78281549"],"apc_list":{"value":1500,"currency":"GBP","value_usd":1839},"apc_paid":{"value":1500,"currency":"GBP","value_usd":1839},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"16","issue":"8","first_page":"e111823","last_page":"e111823"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10038","display_name":"Tuberculosis Research and Epidemiology","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10038","display_name":"Tuberculosis Research and Epidemiology","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11381","display_name":"Infectious Diseases and Tuberculosis","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13586","display_name":"HIV, TB, and STIs Epidemiology","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/multidrug-resistant-tuberculosis","display_name":"multidrug-resistant tuberculosis","score":0.9779999852180481},{"id":"https://openalex.org/keywords/rifampicin-resistance","display_name":"rifampicin resistance","score":0.9900000095367432},{"id":"https://openalex.org/keywords/spatial-clustering","display_name":"spatial clustering","score":0.8769999742507935},{"id":"https://openalex.org/keywords/transmission-networks","display_name":"transmission networks","score":0.8650000095367432},{"id":"https://openalex.org/keywords/whole-genome-sequencing","display_name":"whole genome sequencing","score":0.734000027179718},{"id":"https://openalex.org/keywords/transmission-clusters","display_name":"transmission clusters","score":0.421999990940094},{"id":"https://openalex.org/keywords/population-density","display_name":"population density","score":0.6850000023841858},{"id":"https://openalex.org/keywords/case-notification-rate","display_name":"case notification rate","score":0.7310000061988831},{"id":"https://openalex.org/keywords/administrative-boundaries","display_name":"administrative boundaries","score":0.5429999828338623},{"id":"https://openalex.org/keywords/rwanda","display_name":"Rwanda","score":0.4909999966621399}],"concepts":[{"id":"https://openalex.org/C761482","wikidata":"https://www.wikidata.org/wiki/Q118093","display_name":"Transmission (telecommunications)","level":2,"score":0.7289000153541565},{"id":"https://openalex.org/C73555534","wikidata":"https://www.wikidata.org/wiki/Q622825","display_name":"Cluster analysis","level":2,"score":0.583899974822998},{"id":"https://openalex.org/C186744025","wikidata":"https://www.wikidata.org/wiki/Q7574064","display_name":"Spatial epidemiology","level":3,"score":0.5393999814987183},{"id":"https://openalex.org/C159620131","wikidata":"https://www.wikidata.org/wiki/Q1938983","display_name":"Spatial analysis","level":2,"score":0.4950999915599823},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.47749999165534973},{"id":"https://openalex.org/C2777016058","wikidata":"https://www.wikidata.org/wiki/Q7574061","display_name":"Spatial distribution","level":2,"score":0.4611000120639801},{"id":"https://openalex.org/C158709400","wikidata":"https://www.wikidata.org/wiki/Q3578586","display_name":"Spatial ecology","level":2,"score":0.4560999870300293},{"id":"https://openalex.org/C97669555","wikidata":"https://www.wikidata.org/wiki/Q4118435","display_name":"Molecular epidemiology","level":4,"score":0.446399986743927},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.4424000084400177},{"id":"https://openalex.org/C164866538","wikidata":"https://www.wikidata.org/wiki/Q367351","display_name":"Cluster (spacecraft)","level":2,"score":0.4284999966621399},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.40560001134872437},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.3986999988555908},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.3393000066280365},{"id":"https://openalex.org/C58640448","wikidata":"https://www.wikidata.org/wiki/Q42515","display_name":"Cartography","level":1,"score":0.3142000138759613},{"id":"https://openalex.org/C116675565","wikidata":"https://www.wikidata.org/wiki/Q3241045","display_name":"Outbreak","level":2,"score":0.311599999666214},{"id":"https://openalex.org/C94747663","wikidata":"https://www.wikidata.org/wiki/Q7574086","display_name":"Spatial variability","level":2,"score":0.3073999881744385},{"id":"https://openalex.org/C2781069245","wikidata":"https://www.wikidata.org/wiki/Q12204","display_name":"Tuberculosis","level":2,"score":0.3001999855041504},{"id":"https://openalex.org/C135763542","wikidata":"https://www.wikidata.org/wiki/Q106016","display_name":"Genotype","level":3,"score":0.298799991607666},{"id":"https://openalex.org/C124101348","wikidata":"https://www.wikidata.org/wiki/Q172491","display_name":"Data mining","level":1,"score":0.2935999929904938},{"id":"https://openalex.org/C2777975735","wikidata":"https://www.wikidata.org/wiki/Q130971","display_name":"Mycobacterium tuberculosis","level":3,"score":0.2896000146865845},{"id":"https://openalex.org/C78458016","wikidata":"https://www.wikidata.org/wiki/Q840400","display_name":"Evolutionary biology","level":1,"score":0.27790001034736633},{"id":"https://openalex.org/C193252679","wikidata":"https://www.wikidata.org/wiki/Q242125","display_name":"Phylogenetic tree","level":3,"score":0.27570000290870667},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.2745000123977661},{"id":"https://openalex.org/C177860879","wikidata":"https://www.wikidata.org/wiki/Q5532897","display_name":"Genetic epidemiology","level":3,"score":0.2535000145435333},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2515999972820282}],"mesh":[{"descriptor_ui":"D000073336","descriptor_name":"Whole Genome Sequencing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009169","descriptor_name":"Mycobacterium tuberculosis","qualifier_ui":"Q000235","qualifier_name":"genetics","is_major_topic":true},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012432","descriptor_name":"Rwanda","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D016000","descriptor_name":"Cluster Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018088","descriptor_name":"Tuberculosis, Multidrug-Resistant","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D018088","descriptor_name":"Tuberculosis, Multidrug-Resistant","qualifier_ui":"Q000635","qualifier_name":"transmission","is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1136/bmjopen-2025-111823","doi":"https://doi.org/10.1136/bmjopen-2025-111823","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjopen-2025-111823","pdf_url":null,"source":{"id":"https://openalex.org/S79054089","display_name":"BMJ Open","issn_l":"2044-6055","issn":["2044-6055"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Open","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13536106","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13536106/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13536106/pdf/bmjopen-16-8.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Open","raw_type":"Text"},{"id":"pmid:42648769","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42648769","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ open","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:d0529b80e6184a6d85a7b2cdbd715994","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/d0529b80e6184a6d85a7b2cdbd715994","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMJ Open, Vol 16, Iss 8 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1136/bmjopen-2025-111823","doi":"https://doi.org/10.1136/bmjopen-2025-111823","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjopen-2025-111823","pdf_url":null,"source":{"id":"https://openalex.org/S79054089","display_name":"BMJ Open","issn_l":"2044-6055","issn":["2044-6055"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Open","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.98580002784729}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G2318573441","display_name":null,"funder_award_id":"W001822N","funder_id":"https://openalex.org/F4320321730","funder_display_name":"Fonds Wetenschappelijk Onderzoek"},{"id":"https://openalex.org/G3064555225","display_name":"Culture free diagnosis and follow-up of multidrug resistant tuberculosis patients","funder_award_id":"DRIA2014-326","funder_id":"https://openalex.org/F4320338462","funder_display_name":"European and Developing Countries Clinical Trials Partnership"},{"id":"https://openalex.org/G4800136717","display_name":null,"funder_award_id":"1SE7622N/1SE7624N","funder_id":"https://openalex.org/F4320321730","funder_display_name":"Fonds Wetenschappelijk Onderzoek"},{"id":"https://openalex.org/G5804155925","display_name":"Curbing rifampicin-resistant tuberculosis in Rwanda and beyond","funder_award_id":"1SE7622N","funder_id":"https://openalex.org/F4320321730","funder_display_name":"Fonds Wetenschappelijk Onderzoek"},{"id":"https://openalex.org/G6738937120","display_name":null,"funder_award_id":"SOFI-DIR/av/2020/119","funder_id":"https://openalex.org/F4320335809","funder_display_name":"Departement Economie, Wetenschap en Innovatie"},{"id":"https://openalex.org/G803057187","display_name":null,"funder_award_id":"DRIA2014-326-DIAMA","funder_id":"https://openalex.org/F4320338462","funder_display_name":"European and Developing Countries Clinical Trials Partnership"},{"id":"https://openalex.org/G8600565553","display_name":"Curbing rifampicin-resistant tuberculosis in Rwanda and beyond","funder_award_id":"1SE7624N","funder_id":"https://openalex.org/F4320321730","funder_display_name":"Fonds Wetenschappelijk Onderzoek"}],"funders":[{"id":"https://openalex.org/F4320321730","display_name":"Fonds Wetenschappelijk Onderzoek","ror":"https://ror.org/03qtxy027"},{"id":"https://openalex.org/F4320335809","display_name":"Departement Economie, Wetenschap en Innovatie","ror":"https://ror.org/01g94x362"},{"id":"https://openalex.org/F4320338462","display_name":"European and Developing Countries Clinical Trials Partnership","ror":"https://ror.org/031jv9v19"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204248309.pdf","grobid_xml":"https://content.openalex.org/works/W7204248309.grobid-xml"},"referenced_works_count":42,"referenced_works":["https://openalex.org/W588769813","https://openalex.org/W1970143540","https://openalex.org/W1973074475","https://openalex.org/W2019397416","https://openalex.org/W2020231419","https://openalex.org/W2056780042","https://openalex.org/W2069473179","https://openalex.org/W2087564425","https://openalex.org/W2088606356","https://openalex.org/W2117632799","https://openalex.org/W2124967403","https://openalex.org/W2150469424","https://openalex.org/W2168326617","https://openalex.org/W2176621021","https://openalex.org/W2177087965","https://openalex.org/W2305153653","https://openalex.org/W2537428622","https://openalex.org/W2586868702","https://openalex.org/W2602169678","https://openalex.org/W2766200396","https://openalex.org/W2800559610","https://openalex.org/W2884781181","https://openalex.org/W2887189210","https://openalex.org/W2901029329","https://openalex.org/W2905129234","https://openalex.org/W2949867654","https://openalex.org/W2982388963","https://openalex.org/W3013159759","https://openalex.org/W3018973696","https://openalex.org/W3033997413","https://openalex.org/W3087197842","https://openalex.org/W3138438534","https://openalex.org/W4207034028","https://openalex.org/W4210594876","https://openalex.org/W4224950071","https://openalex.org/W4281747322","https://openalex.org/W4365140258","https://openalex.org/W4375950612","https://openalex.org/W4392370564","https://openalex.org/W4393210575","https://openalex.org/W4407957711","https://openalex.org/W4408746302"],"related_works":["https://openalex.org/W7203911505","https://openalex.org/W4207034028","https://openalex.org/W3152108049","https://openalex.org/W7161634945","https://openalex.org/W3164398939","https://openalex.org/W2970329550","https://openalex.org/W4200372893","https://openalex.org/W2586868702","https://openalex.org/W7147052091","https://openalex.org/W3138438534"],"abstract_inverted_index":{"BACKGROUND:":[0],"Approximately":[1],"96%":[2],"of":[3,27,39,60,75,129,166,189],"rifampicin":[4],"resistance/multidrug-resistant":[5],"tuberculosis":[6],"(RR/MDR-TB)":[7],"cases":[8,64,99,167],"in":[9,41,133,137,228,276],"Rwanda":[10,42,66,229,277],"result":[11],"from":[12,67],"direct":[13],"transmission":[14,25,106,115,196,206,220,235,249,272],"rather":[15],"than":[16],"acquired":[17],"resistance.":[18],"However,":[19],"the":[20,72,190,262],"nationwide":[21],"spatial":[22,37,47,119,127,232,246],"distribution":[23],"and":[24,43,49,79,89,117,141,204,240,245,256],"dynamics":[26],"RR/MDR-TB":[28,40,50,130,227,275],"remain":[29],"poorly":[30],"characterised.":[31],"This":[32],"study":[33],"aims":[34],"to":[35,69,112,169,264,273],"analyse":[36],"patterns":[38,250],"explore":[44],"relationships":[45,120],"between":[46],"proximity":[48],"strains'":[51],"genetic":[52],"relatedness.":[53],"METHODS:":[54],"We":[55],"conducted":[56],"a":[57,109,174,182],"retrospective":[58],"analysis":[59,107,150,163,188],"249":[61],"confirmed":[62],"RR-TB":[63],"across":[65,223],"2017":[68],"2024,":[70],"using":[71,84,94,108,173],"known":[73],"geolocations":[74],"patients'":[76],"residences.":[77],"Spatial":[78,186],"space-time":[80],"clustering":[81,128,233],"was":[82,131],"assessed":[83],"Kulldorff's":[85],"scan":[86],"statistics.":[87],"Demographic":[88],"socioeconomic":[90],"determinants":[91],"were":[92],"evaluated":[93],"multivariable":[95,149],"regression.":[96],"For":[97],"201":[98],"with":[100,158,177,234],"whole-genome":[101],"sequencing":[102],"data,":[103],"we":[104],"performed":[105],"5-SNP":[110,184],"threshold":[111],"define":[113],"recent":[114],"clusters":[116,171,180,193,213],"investigated":[118],"within":[121],"genetically":[122],"related":[123],"strains.":[124],"RESULTS:":[125],"Significant":[126],"identified":[132],"21":[134],"sectors,":[135],"mainly":[136],"Nyarugenge,":[138],"southern":[139],"Gasabo":[140],"western":[142],"Kicukiro":[143],"(relative":[144],"risk:":[145],"10.06;":[146],"p<0.001).":[147],"Our":[148],"showed":[151],"that":[152,208,219,251,269],"population":[153],"density":[154],"is":[155],"positively":[156],"associated":[157],"case":[159],"notification":[160],"rates.":[161],"Molecular":[162],"revealed":[164,194],"88.5%":[165],"belonged":[168],"genotype":[170],"defined":[172],"12-SNP":[175],"threshold,":[176],"73.6%":[178],"forming":[179],"at":[181],"strict":[183],"threshold.":[185],"K-function":[187],"six":[191],"major":[192],"heterogeneous":[195],"patterns,":[197],"characterised":[198],"by":[199],"both":[200,238],"tightly":[201],"clustered":[202],"outbreaks":[203],"regional":[205,241],"networks":[207,221],"spanned":[209],"administrative":[210,224,257],"boundaries.":[211,258],"Most":[212],"(5/6)":[214],"extended":[215],"beyond":[216,253],"Kigali,":[217],"indicating":[218],"operate":[222],"divides.":[225],"CONCLUSION:":[226],"shows":[230],"significant":[231],"occurring":[236],"through":[237],"localised":[239],"networks.":[242],"Integrating":[243],"genomic":[244],"data":[247],"reveals":[248],"extend":[252],"household":[254],"contacts":[255],"These":[259],"findings":[260],"underscore":[261],"need":[263],"implement":[265],"geographically":[266],"targeted":[267],"interventions":[268],"address":[270],"community-level":[271],"control":[274],"effectively.":[278]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-08-27T00:00:00"}
