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Intensified household contact tracing, prevention and treatment support versus enhanced standard of care for contacts of tuberculosis cases in South Africa: Study protocol for a household cluster-randomised trial

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MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613, Webb, Emily, Variava, Ebrahim, Lala, Sanjay, Milovanovic, Minja, Ratsela, Andrew, Lebina, Limakatso, Kinghorn, Anthony and Martinson, Neil (2019) 'Intensified household contact tracing, prevention and treatment support versus enhanced standard of care for contacts of tuberculosis cases in South Africa: Study protocol for a household cluster-randomised trial'. BMC Infectious Diseases, Vol 19, Issue 839.

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Abstract

Background
Household contact tracing of index TB cases has been advocated as a key part of TB control for many years, but has not been widely implemented in many low-resource setting because of the current dearth of high quality evidence for effectiveness. Innovative strategies for earlier, more effective treatment are particularly important in contexts with hyper-endemic levels of HIV, where levels of TB infection remain extremely high.
Methods
We present the design of a household cluster-randomised controlled trial of interventions aimed at improving TB-free survival and reducing childhood prevalence of Mycobacterium tuberculosis infection among household contacts of index TB cases diagnosed in two provinces of South Africa. Households of index TB cases will be randomly allocated in a 1:1 ratio to receive either an intensified home screening and linkage for TB and HIV intervention, or enhanced standard of care. The primary outcome will compare between groups the TB-free survival of household contacts over 15 months. All participants, or their next-of-kin, will provide written informed consent to participate
Discussion
Evidence from randomised trials is required to identify cost-effective approaches to TB case-finding that can be applied at scale in sub-Saharan Africa.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 205 Epidemiology
WF Respiratory System > Tuberculosis > WF 205.1 General coverage
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-019-4502-5
Depositing User: Stacy Murtagh
Date Deposited: 14 Oct 2019 10:40
Last Modified: 14 Oct 2019 10:49
URI: https://archive.lstmed.ac.uk/id/eprint/12581

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