Data from: Home-based TB contact investigation in Uganda: a household-randomized trial
Cite this dataset
Davis, Lucian et al. (2020). Data from: Home-based TB contact investigation in Uganda: a household-randomized trial [Dataset]. Dryad. https://doi.org/10.5061/dryad.kn4gv14
Introduction: The World Health Organization(WHO) recommends household tuberculosis(TB) contact investigation in low-income countries, but most contacts do not complete evaluation. Methods: We performed a randomized trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers(CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic(standard-of-care) or home(intervention) evaluation. In the intervention arm, CHWs offered adults HIV testing; collected sputum from symptomatic contacts and persons living with HIV(PLWH) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWH, children <5, and anyone unable to complete sputum testing to clinic. Sputum-testing results and/or follow-up instructions were returned by automated SMS. The primary outcome was completion of TB evaluation within 14 days; secondary, TB and HIV diagnoses and treatments among screened contacts. Results: There were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471(40%) intervention and 213/448(48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91(39%) sputum-eligible contacts and SMS were sent to 95/190(50%) contacts. Completion of TB evaluation in intervention and standard-of-care arms at 14 days(14% vs 15%; difference -1%, 95%CI -9% to +7%, p=0.81) and yields of confirmed TB(1.5% vs 1.1%, p=0.62) and new HIV(2.0% vs. 1.8%, p=0.90) diagnoses were similar. Conclusions: Home-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components.