Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial
Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of commun...
Gespeichert in:
| Veröffentlicht in: | The Lancet global health 2023-12, Vol.11 (12), p.e1911-e1921 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e1921 |
|---|---|
| container_issue | 12 |
| container_start_page | e1911 |
| container_title | The Lancet global health |
| container_volume | 11 |
| creator | Bonnet, Maryline Vasiliu, Anca Tchounga, Boris K Cuer, Benjamin Fielding, Katherine Ssekyanzi, Bob Tchakounte Youngui, Boris Cohn, Jennifer Dodd, Peter J Tiendrebeogo, Georges Tchendjou, Patrice Simo, Leonie Okello, Richard F Kuate Kuate, Albert Turyahabwe, Stavia Atwine, Daniel Graham, Stephen M Casenghi, Martina Chauvet, Savine de Carvalho, Elisabete Ouedraogo, Sayouba Leguicher, Gwenvael Tiam, Appolinaire Oziemkowska, Maria Atieno Ayuo, Elizabeth Mafirakureva, Nyashadzaishe Berset, Maude Lemaire, Jean-Francois Sih, Collette Kana, Rogacien Youm, Eric Guedem Nekame, Jinette Lorraine Manguele, Paul Williams Bindzi, Paul Ndongo, Marie-Louise Aimée Ndjang Kombou, Doline Tsigaing, Philippe Narcisse Mbunka Awolu, Muhamed Seuleu Ndjamakou, Leticia Grace Sitamze Kaptue, Narcisse Ngounou Moyo, Dany Flora Patouokoumche Ngouh, Raimatou Kouotou Mouliom, Joseph Stéphane Abogo Abatsong, Henriette Alida Essebe Ngangue, Rose Cynthia Djeumene, Rodrigue Maguia Tatiane Kouam, Laure Tatiane Nono Djilo, Lydie Flore Bakmano Raïssa, Marie-Josée Njikeh, Kong Derick Bissek, Anne-Cécile Arinaitwe, Rinah Otai, David Kamanzi, Hamidah Natukunda, Agnes Natukunda, Eva Kyarimpa, Rose Kyomuhendo, Doreen Sanyu, Scovia Ssemanya, John Nabbuto, Jane Lugoose, Ssuan Rachael, Kiconco Tebylwa Beryta, Jonanita Kitakule, Frank Atuhaire, Syson Kembabazi, Moreen Abok, Florence Kakinda, Michael Odongo, Dickens Ijjo, Henri Kyomugisha, Clemencia Aryatuhwera, Johnan Ashaba, Beth Nuwamanya, Patrick Arinaitwe, Merdard Natukunda, Prisca Muhangi, Collins Muhumuza, Deogratious Ndyeimuka, Gordon Bagabe, Johnson Tiboruhanga, Justus Tibaijuka, Francis Nahabwe, Marion |
| description | Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of community-based approaches to tuberculosis contact investigations in Cameroon and Uganda.
We did a parallel, cluster-randomised, controlled trial across 20 clusters (consisting of 25 district hospitals and primary health centres) in Cameroon and Uganda, which were randomised (1:1) to receive a community-based approach (intervention group) or standard-of-care facility-based approach to contact screening and management (control group). The community-based approach consisted of symptom-based tuberculosis screening of all household contacts by community health workers at the household, with referral of symptomatic contacts to local facilities for investigations. Initiation of TPT (3-month course of rifampicin–isoniazid) was done by a nurse in the household, and home visits for TPT follow-up were done by community health workers. Index patients were people aged 15 years or older with bacteriologically confirmed, drug-susceptible, pulmonary tuberculosis diagnosed less than 1 month before inclusion and who declared at least one child or young adolescent (aged 0–14 years) household contact. The primary endpoint was the proportion of declared child contacts in the TPT target group (those aged 2 months) and ten in the control group. Between Oct 14, 2019 and Jan 13, 2022, 2894 child contacts were declared by 899 index patients with bacteriologically confirmed tuberculosis. Among all child contacts declared, 1548 (81·9%) of 1889 in the intervention group and 475 (47·3%) of 1005 in the control group were screened for tuberculosis. 1400 (48·4%) child contacts were considered to be in the TPT target group: 941 (49·8%) of 1889 |
| doi_str_mv | 10.1016/S2214-109X(23)00430-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2886331858</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2214109X23004308</els_id><sourcerecordid>2886331858</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-5dc4fd765150228483e55875d784e64ec3d021b637a7fca7a60e441599a0c30c3</originalsourceid><addsrcrecordid>eNqFUV1rFDEUHUSxpfYnKHmsD6P5nGR8EVnqBxR80IJvIZvc2YnMJGuS2dLf5R80012Lb4aQGy7nnnMPp2leEvyGYNK9_UYp4S3B_Y8ryl5jzBlu1ZPm_LH99J__WXOZ809cT98zKuXz5ozJnihO5Hnz-3oYwBZ_gAA5ozggg2yc5yX4ct9uTQaHzH6forEjGmJCZQTkwwFy8TtTfAzIBIdmE8wOZghlpbCjn1yCgO58GdEYlwxjnBwqyxaSXaaYfa4qoRhbKhnamBlSPFHd7upr3q17TEsukNpUG3H26yoleTO9aJ4NZspweaoXze3H6--bz-3N109fNh9uWssJLa1wlg9OdoIITKniioEQSgonFYeOg2UOU7LtmDRysEaaDgPnRPS9wZbVe9FcHXmr_V9LdazrEhamyQSonjRVqmOMKKEqVByhNsWcEwx6n_xs0r0mWK-R6YfI9JqHpkw_RKbXuVcniWU7g3uc-htQBbw_AqAaPXhIOlsPwYLzqeamXfT_kfgDMRqp7Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2886331858</pqid></control><display><type>article</type><title>Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Bonnet, Maryline ; Vasiliu, Anca ; Tchounga, Boris K ; Cuer, Benjamin ; Fielding, Katherine ; Ssekyanzi, Bob ; Tchakounte Youngui, Boris ; Cohn, Jennifer ; Dodd, Peter J ; Tiendrebeogo, Georges ; Tchendjou, Patrice ; Simo, Leonie ; Okello, Richard F ; Kuate Kuate, Albert ; Turyahabwe, Stavia ; Atwine, Daniel ; Graham, Stephen M ; Casenghi, Martina ; Chauvet, Savine ; de Carvalho, Elisabete ; Ouedraogo, Sayouba ; Leguicher, Gwenvael ; Tiam, Appolinaire ; Oziemkowska, Maria ; Atieno Ayuo, Elizabeth ; Mafirakureva, Nyashadzaishe ; Berset, Maude ; Lemaire, Jean-Francois ; Sih, Collette ; Kana, Rogacien ; Youm, Eric ; Guedem Nekame, Jinette Lorraine ; Manguele, Paul Williams ; Bindzi, Paul ; Ndongo, Marie-Louise Aimée ; Ndjang Kombou, Doline ; Tsigaing, Philippe Narcisse ; Mbunka Awolu, Muhamed ; Seuleu Ndjamakou, Leticia Grace ; Sitamze Kaptue, Narcisse ; Ngounou Moyo, Dany Flora ; Patouokoumche Ngouh, Raimatou ; Kouotou Mouliom, Joseph Stéphane ; Abogo Abatsong, Henriette Alida ; Essebe Ngangue, Rose Cynthia ; Djeumene, Rodrigue ; Maguia Tatiane Kouam, Laure Tatiane ; Nono Djilo, Lydie Flore ; Bakmano Raïssa, Marie-Josée ; Njikeh, Kong Derick ; Bissek, Anne-Cécile ; Arinaitwe, Rinah ; Otai, David ; Kamanzi, Hamidah ; Natukunda, Agnes ; Natukunda, Eva ; Kyarimpa, Rose ; Kyomuhendo, Doreen ; Sanyu, Scovia ; Ssemanya, John ; Nabbuto, Jane ; Lugoose, Ssuan ; Rachael, Kiconco ; Tebylwa Beryta, Jonanita ; Kitakule, Frank ; Atuhaire, Syson ; Kembabazi, Moreen ; Abok, Florence ; Kakinda, Michael ; Odongo, Dickens ; Ijjo, Henri ; Kyomugisha, Clemencia ; Aryatuhwera, Johnan ; Ashaba, Beth ; Nuwamanya, Patrick ; Arinaitwe, Merdard ; Natukunda, Prisca ; Muhangi, Collins ; Muhumuza, Deogratious ; Ndyeimuka, Gordon ; Bagabe, Johnson ; Tiboruhanga, Justus ; Tibaijuka, Francis ; Nahabwe, Marion</creator><creatorcontrib>Bonnet, Maryline ; Vasiliu, Anca ; Tchounga, Boris K ; Cuer, Benjamin ; Fielding, Katherine ; Ssekyanzi, Bob ; Tchakounte Youngui, Boris ; Cohn, Jennifer ; Dodd, Peter J ; Tiendrebeogo, Georges ; Tchendjou, Patrice ; Simo, Leonie ; Okello, Richard F ; Kuate Kuate, Albert ; Turyahabwe, Stavia ; Atwine, Daniel ; Graham, Stephen M ; Casenghi, Martina ; Chauvet, Savine ; de Carvalho, Elisabete ; Ouedraogo, Sayouba ; Leguicher, Gwenvael ; Tiam, Appolinaire ; Oziemkowska, Maria ; Atieno Ayuo, Elizabeth ; Mafirakureva, Nyashadzaishe ; Berset, Maude ; Lemaire, Jean-Francois ; Sih, Collette ; Kana, Rogacien ; Youm, Eric ; Guedem Nekame, Jinette Lorraine ; Manguele, Paul Williams ; Bindzi, Paul ; Ndongo, Marie-Louise Aimée ; Ndjang Kombou, Doline ; Tsigaing, Philippe Narcisse ; Mbunka Awolu, Muhamed ; Seuleu Ndjamakou, Leticia Grace ; Sitamze Kaptue, Narcisse ; Ngounou Moyo, Dany Flora ; Patouokoumche Ngouh, Raimatou ; Kouotou Mouliom, Joseph Stéphane ; Abogo Abatsong, Henriette Alida ; Essebe Ngangue, Rose Cynthia ; Djeumene, Rodrigue ; Maguia Tatiane Kouam, Laure Tatiane ; Nono Djilo, Lydie Flore ; Bakmano Raïssa, Marie-Josée ; Njikeh, Kong Derick ; Bissek, Anne-Cécile ; Arinaitwe, Rinah ; Otai, David ; Kamanzi, Hamidah ; Natukunda, Agnes ; Natukunda, Eva ; Kyarimpa, Rose ; Kyomuhendo, Doreen ; Sanyu, Scovia ; Ssemanya, John ; Nabbuto, Jane ; Lugoose, Ssuan ; Rachael, Kiconco ; Tebylwa Beryta, Jonanita ; Kitakule, Frank ; Atuhaire, Syson ; Kembabazi, Moreen ; Abok, Florence ; Kakinda, Michael ; Odongo, Dickens ; Ijjo, Henri ; Kyomugisha, Clemencia ; Aryatuhwera, Johnan ; Ashaba, Beth ; Nuwamanya, Patrick ; Arinaitwe, Merdard ; Natukunda, Prisca ; Muhangi, Collins ; Muhumuza, Deogratious ; Ndyeimuka, Gordon ; Bagabe, Johnson ; Tiboruhanga, Justus ; Tibaijuka, Francis ; Nahabwe, Marion ; CONTACT study group</creatorcontrib><description>Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of community-based approaches to tuberculosis contact investigations in Cameroon and Uganda.
We did a parallel, cluster-randomised, controlled trial across 20 clusters (consisting of 25 district hospitals and primary health centres) in Cameroon and Uganda, which were randomised (1:1) to receive a community-based approach (intervention group) or standard-of-care facility-based approach to contact screening and management (control group). The community-based approach consisted of symptom-based tuberculosis screening of all household contacts by community health workers at the household, with referral of symptomatic contacts to local facilities for investigations. Initiation of TPT (3-month course of rifampicin–isoniazid) was done by a nurse in the household, and home visits for TPT follow-up were done by community health workers. Index patients were people aged 15 years or older with bacteriologically confirmed, drug-susceptible, pulmonary tuberculosis diagnosed less than 1 month before inclusion and who declared at least one child or young adolescent (aged 0–14 years) household contact. The primary endpoint was the proportion of declared child contacts in the TPT target group (those aged <5 years irrespective of HIV status, and children aged 5–14 years living with HIV) who commenced and completed TPT, assessed in the modified intention-to-treat population (excluding enrolled index patients and their contacts who did not fit the eligibility criteria). Descriptive cascade of care assessment and generalised linear mixed modelling were used for comparison. This study is registered with ClinicalTrials.gov (NCT03832023).
The study included nine clusters in the intervention group (after excluding one cluster that did not enrol any index patients for >2 months) and ten in the control group. Between Oct 14, 2019 and Jan 13, 2022, 2894 child contacts were declared by 899 index patients with bacteriologically confirmed tuberculosis. Among all child contacts declared, 1548 (81·9%) of 1889 in the intervention group and 475 (47·3%) of 1005 in the control group were screened for tuberculosis. 1400 (48·4%) child contacts were considered to be in the TPT target group: 941 (49·8%) of 1889 in the intervention group and 459 (45·7%) of 1005 in the control group. In the TPT target group, TPT was commenced and completed in 752 (79·9%) of 941 child contacts in the intervention group and 283 (61·7%) of 459 in the control group (odds ratio 3·06 [95% CI 1·24–7·53]).
A community-based approach using community health workers can significantly increase contact investigation coverage and TPT completion among eligible child contacts in a tuberculosis-endemic setting.
Unitaid.
For the French translation of the abstract see Supplementary Materials section.</description><identifier>ISSN: 2214-109X</identifier><identifier>EISSN: 2214-109X</identifier><identifier>DOI: 10.1016/S2214-109X(23)00430-8</identifier><identifier>PMID: 37918417</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Cameroon - epidemiology ; Child ; Child, Preschool ; HIV Infections ; Humans ; Infant ; Infant, Newborn ; Tuberculosis - diagnosis ; Tuberculosis - drug therapy ; Tuberculosis - prevention & control ; Tuberculosis, Pulmonary - diagnosis ; Tuberculosis, Pulmonary - drug therapy ; Tuberculosis, Pulmonary - prevention & control ; Uganda - epidemiology</subject><ispartof>The Lancet global health, 2023-12, Vol.11 (12), p.e1911-e1921</ispartof><rights>2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-5dc4fd765150228483e55875d784e64ec3d021b637a7fca7a60e441599a0c30c3</citedby><cites>FETCH-LOGICAL-c412t-5dc4fd765150228483e55875d784e64ec3d021b637a7fca7a60e441599a0c30c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37918417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bonnet, Maryline</creatorcontrib><creatorcontrib>Vasiliu, Anca</creatorcontrib><creatorcontrib>Tchounga, Boris K</creatorcontrib><creatorcontrib>Cuer, Benjamin</creatorcontrib><creatorcontrib>Fielding, Katherine</creatorcontrib><creatorcontrib>Ssekyanzi, Bob</creatorcontrib><creatorcontrib>Tchakounte Youngui, Boris</creatorcontrib><creatorcontrib>Cohn, Jennifer</creatorcontrib><creatorcontrib>Dodd, Peter J</creatorcontrib><creatorcontrib>Tiendrebeogo, Georges</creatorcontrib><creatorcontrib>Tchendjou, Patrice</creatorcontrib><creatorcontrib>Simo, Leonie</creatorcontrib><creatorcontrib>Okello, Richard F</creatorcontrib><creatorcontrib>Kuate Kuate, Albert</creatorcontrib><creatorcontrib>Turyahabwe, Stavia</creatorcontrib><creatorcontrib>Atwine, Daniel</creatorcontrib><creatorcontrib>Graham, Stephen M</creatorcontrib><creatorcontrib>Casenghi, Martina</creatorcontrib><creatorcontrib>Chauvet, Savine</creatorcontrib><creatorcontrib>de Carvalho, Elisabete</creatorcontrib><creatorcontrib>Ouedraogo, Sayouba</creatorcontrib><creatorcontrib>Leguicher, Gwenvael</creatorcontrib><creatorcontrib>Tiam, Appolinaire</creatorcontrib><creatorcontrib>Oziemkowska, Maria</creatorcontrib><creatorcontrib>Atieno Ayuo, Elizabeth</creatorcontrib><creatorcontrib>Mafirakureva, Nyashadzaishe</creatorcontrib><creatorcontrib>Berset, Maude</creatorcontrib><creatorcontrib>Lemaire, Jean-Francois</creatorcontrib><creatorcontrib>Sih, Collette</creatorcontrib><creatorcontrib>Kana, Rogacien</creatorcontrib><creatorcontrib>Youm, Eric</creatorcontrib><creatorcontrib>Guedem Nekame, Jinette Lorraine</creatorcontrib><creatorcontrib>Manguele, Paul Williams</creatorcontrib><creatorcontrib>Bindzi, Paul</creatorcontrib><creatorcontrib>Ndongo, Marie-Louise Aimée</creatorcontrib><creatorcontrib>Ndjang Kombou, Doline</creatorcontrib><creatorcontrib>Tsigaing, Philippe Narcisse</creatorcontrib><creatorcontrib>Mbunka Awolu, Muhamed</creatorcontrib><creatorcontrib>Seuleu Ndjamakou, Leticia Grace</creatorcontrib><creatorcontrib>Sitamze Kaptue, Narcisse</creatorcontrib><creatorcontrib>Ngounou Moyo, Dany Flora</creatorcontrib><creatorcontrib>Patouokoumche Ngouh, Raimatou</creatorcontrib><creatorcontrib>Kouotou Mouliom, Joseph Stéphane</creatorcontrib><creatorcontrib>Abogo Abatsong, Henriette Alida</creatorcontrib><creatorcontrib>Essebe Ngangue, Rose Cynthia</creatorcontrib><creatorcontrib>Djeumene, Rodrigue</creatorcontrib><creatorcontrib>Maguia Tatiane Kouam, Laure Tatiane</creatorcontrib><creatorcontrib>Nono Djilo, Lydie Flore</creatorcontrib><creatorcontrib>Bakmano Raïssa, Marie-Josée</creatorcontrib><creatorcontrib>Njikeh, Kong Derick</creatorcontrib><creatorcontrib>Bissek, Anne-Cécile</creatorcontrib><creatorcontrib>Arinaitwe, Rinah</creatorcontrib><creatorcontrib>Otai, David</creatorcontrib><creatorcontrib>Kamanzi, Hamidah</creatorcontrib><creatorcontrib>Natukunda, Agnes</creatorcontrib><creatorcontrib>Natukunda, Eva</creatorcontrib><creatorcontrib>Kyarimpa, Rose</creatorcontrib><creatorcontrib>Kyomuhendo, Doreen</creatorcontrib><creatorcontrib>Sanyu, Scovia</creatorcontrib><creatorcontrib>Ssemanya, John</creatorcontrib><creatorcontrib>Nabbuto, Jane</creatorcontrib><creatorcontrib>Lugoose, Ssuan</creatorcontrib><creatorcontrib>Rachael, Kiconco</creatorcontrib><creatorcontrib>Tebylwa Beryta, Jonanita</creatorcontrib><creatorcontrib>Kitakule, Frank</creatorcontrib><creatorcontrib>Atuhaire, Syson</creatorcontrib><creatorcontrib>Kembabazi, Moreen</creatorcontrib><creatorcontrib>Abok, Florence</creatorcontrib><creatorcontrib>Kakinda, Michael</creatorcontrib><creatorcontrib>Odongo, Dickens</creatorcontrib><creatorcontrib>Ijjo, Henri</creatorcontrib><creatorcontrib>Kyomugisha, Clemencia</creatorcontrib><creatorcontrib>Aryatuhwera, Johnan</creatorcontrib><creatorcontrib>Ashaba, Beth</creatorcontrib><creatorcontrib>Nuwamanya, Patrick</creatorcontrib><creatorcontrib>Arinaitwe, Merdard</creatorcontrib><creatorcontrib>Natukunda, Prisca</creatorcontrib><creatorcontrib>Muhangi, Collins</creatorcontrib><creatorcontrib>Muhumuza, Deogratious</creatorcontrib><creatorcontrib>Ndyeimuka, Gordon</creatorcontrib><creatorcontrib>Bagabe, Johnson</creatorcontrib><creatorcontrib>Tiboruhanga, Justus</creatorcontrib><creatorcontrib>Tibaijuka, Francis</creatorcontrib><creatorcontrib>Nahabwe, Marion</creatorcontrib><creatorcontrib>CONTACT study group</creatorcontrib><title>Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial</title><title>The Lancet global health</title><addtitle>Lancet Glob Health</addtitle><description>Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of community-based approaches to tuberculosis contact investigations in Cameroon and Uganda.
We did a parallel, cluster-randomised, controlled trial across 20 clusters (consisting of 25 district hospitals and primary health centres) in Cameroon and Uganda, which were randomised (1:1) to receive a community-based approach (intervention group) or standard-of-care facility-based approach to contact screening and management (control group). The community-based approach consisted of symptom-based tuberculosis screening of all household contacts by community health workers at the household, with referral of symptomatic contacts to local facilities for investigations. Initiation of TPT (3-month course of rifampicin–isoniazid) was done by a nurse in the household, and home visits for TPT follow-up were done by community health workers. Index patients were people aged 15 years or older with bacteriologically confirmed, drug-susceptible, pulmonary tuberculosis diagnosed less than 1 month before inclusion and who declared at least one child or young adolescent (aged 0–14 years) household contact. The primary endpoint was the proportion of declared child contacts in the TPT target group (those aged <5 years irrespective of HIV status, and children aged 5–14 years living with HIV) who commenced and completed TPT, assessed in the modified intention-to-treat population (excluding enrolled index patients and their contacts who did not fit the eligibility criteria). Descriptive cascade of care assessment and generalised linear mixed modelling were used for comparison. This study is registered with ClinicalTrials.gov (NCT03832023).
The study included nine clusters in the intervention group (after excluding one cluster that did not enrol any index patients for >2 months) and ten in the control group. Between Oct 14, 2019 and Jan 13, 2022, 2894 child contacts were declared by 899 index patients with bacteriologically confirmed tuberculosis. Among all child contacts declared, 1548 (81·9%) of 1889 in the intervention group and 475 (47·3%) of 1005 in the control group were screened for tuberculosis. 1400 (48·4%) child contacts were considered to be in the TPT target group: 941 (49·8%) of 1889 in the intervention group and 459 (45·7%) of 1005 in the control group. In the TPT target group, TPT was commenced and completed in 752 (79·9%) of 941 child contacts in the intervention group and 283 (61·7%) of 459 in the control group (odds ratio 3·06 [95% CI 1·24–7·53]).
A community-based approach using community health workers can significantly increase contact investigation coverage and TPT completion among eligible child contacts in a tuberculosis-endemic setting.
Unitaid.
For the French translation of the abstract see Supplementary Materials section.</description><subject>Adolescent</subject><subject>Cameroon - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>HIV Infections</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Tuberculosis - diagnosis</subject><subject>Tuberculosis - drug therapy</subject><subject>Tuberculosis - prevention & control</subject><subject>Tuberculosis, Pulmonary - diagnosis</subject><subject>Tuberculosis, Pulmonary - drug therapy</subject><subject>Tuberculosis, Pulmonary - prevention & control</subject><subject>Uganda - epidemiology</subject><issn>2214-109X</issn><issn>2214-109X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUV1rFDEUHUSxpfYnKHmsD6P5nGR8EVnqBxR80IJvIZvc2YnMJGuS2dLf5R80012Lb4aQGy7nnnMPp2leEvyGYNK9_UYp4S3B_Y8ryl5jzBlu1ZPm_LH99J__WXOZ809cT98zKuXz5ozJnihO5Hnz-3oYwBZ_gAA5ozggg2yc5yX4ct9uTQaHzH6forEjGmJCZQTkwwFy8TtTfAzIBIdmE8wOZghlpbCjn1yCgO58GdEYlwxjnBwqyxaSXaaYfa4qoRhbKhnamBlSPFHd7upr3q17TEsukNpUG3H26yoleTO9aJ4NZspweaoXze3H6--bz-3N109fNh9uWssJLa1wlg9OdoIITKniioEQSgonFYeOg2UOU7LtmDRysEaaDgPnRPS9wZbVe9FcHXmr_V9LdazrEhamyQSonjRVqmOMKKEqVByhNsWcEwx6n_xs0r0mWK-R6YfI9JqHpkw_RKbXuVcniWU7g3uc-htQBbw_AqAaPXhIOlsPwYLzqeamXfT_kfgDMRqp7Q</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Bonnet, Maryline</creator><creator>Vasiliu, Anca</creator><creator>Tchounga, Boris K</creator><creator>Cuer, Benjamin</creator><creator>Fielding, Katherine</creator><creator>Ssekyanzi, Bob</creator><creator>Tchakounte Youngui, Boris</creator><creator>Cohn, Jennifer</creator><creator>Dodd, Peter J</creator><creator>Tiendrebeogo, Georges</creator><creator>Tchendjou, Patrice</creator><creator>Simo, Leonie</creator><creator>Okello, Richard F</creator><creator>Kuate Kuate, Albert</creator><creator>Turyahabwe, Stavia</creator><creator>Atwine, Daniel</creator><creator>Graham, Stephen M</creator><creator>Casenghi, Martina</creator><creator>Chauvet, Savine</creator><creator>de Carvalho, Elisabete</creator><creator>Ouedraogo, Sayouba</creator><creator>Leguicher, Gwenvael</creator><creator>Tiam, Appolinaire</creator><creator>Oziemkowska, Maria</creator><creator>Atieno Ayuo, Elizabeth</creator><creator>Mafirakureva, Nyashadzaishe</creator><creator>Berset, Maude</creator><creator>Lemaire, Jean-Francois</creator><creator>Sih, Collette</creator><creator>Kana, Rogacien</creator><creator>Youm, Eric</creator><creator>Guedem Nekame, Jinette Lorraine</creator><creator>Manguele, Paul Williams</creator><creator>Bindzi, Paul</creator><creator>Ndongo, Marie-Louise Aimée</creator><creator>Ndjang Kombou, Doline</creator><creator>Tsigaing, Philippe Narcisse</creator><creator>Mbunka Awolu, Muhamed</creator><creator>Seuleu Ndjamakou, Leticia Grace</creator><creator>Sitamze Kaptue, Narcisse</creator><creator>Ngounou Moyo, Dany Flora</creator><creator>Patouokoumche Ngouh, Raimatou</creator><creator>Kouotou Mouliom, Joseph Stéphane</creator><creator>Abogo Abatsong, Henriette Alida</creator><creator>Essebe Ngangue, Rose Cynthia</creator><creator>Djeumene, Rodrigue</creator><creator>Maguia Tatiane Kouam, Laure Tatiane</creator><creator>Nono Djilo, Lydie Flore</creator><creator>Bakmano Raïssa, Marie-Josée</creator><creator>Njikeh, Kong Derick</creator><creator>Bissek, Anne-Cécile</creator><creator>Arinaitwe, Rinah</creator><creator>Otai, David</creator><creator>Kamanzi, Hamidah</creator><creator>Natukunda, Agnes</creator><creator>Natukunda, Eva</creator><creator>Kyarimpa, Rose</creator><creator>Kyomuhendo, Doreen</creator><creator>Sanyu, Scovia</creator><creator>Ssemanya, John</creator><creator>Nabbuto, Jane</creator><creator>Lugoose, Ssuan</creator><creator>Rachael, Kiconco</creator><creator>Tebylwa Beryta, Jonanita</creator><creator>Kitakule, Frank</creator><creator>Atuhaire, Syson</creator><creator>Kembabazi, Moreen</creator><creator>Abok, Florence</creator><creator>Kakinda, Michael</creator><creator>Odongo, Dickens</creator><creator>Ijjo, Henri</creator><creator>Kyomugisha, Clemencia</creator><creator>Aryatuhwera, Johnan</creator><creator>Ashaba, Beth</creator><creator>Nuwamanya, Patrick</creator><creator>Arinaitwe, Merdard</creator><creator>Natukunda, Prisca</creator><creator>Muhangi, Collins</creator><creator>Muhumuza, Deogratious</creator><creator>Ndyeimuka, Gordon</creator><creator>Bagabe, Johnson</creator><creator>Tiboruhanga, Justus</creator><creator>Tibaijuka, Francis</creator><creator>Nahabwe, Marion</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202312</creationdate><title>Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial</title><author>Bonnet, Maryline ; Vasiliu, Anca ; Tchounga, Boris K ; Cuer, Benjamin ; Fielding, Katherine ; Ssekyanzi, Bob ; Tchakounte Youngui, Boris ; Cohn, Jennifer ; Dodd, Peter J ; Tiendrebeogo, Georges ; Tchendjou, Patrice ; Simo, Leonie ; Okello, Richard F ; Kuate Kuate, Albert ; Turyahabwe, Stavia ; Atwine, Daniel ; Graham, Stephen M ; Casenghi, Martina ; Chauvet, Savine ; de Carvalho, Elisabete ; Ouedraogo, Sayouba ; Leguicher, Gwenvael ; Tiam, Appolinaire ; Oziemkowska, Maria ; Atieno Ayuo, Elizabeth ; Mafirakureva, Nyashadzaishe ; Berset, Maude ; Lemaire, Jean-Francois ; Sih, Collette ; Kana, Rogacien ; Youm, Eric ; Guedem Nekame, Jinette Lorraine ; Manguele, Paul Williams ; Bindzi, Paul ; Ndongo, Marie-Louise Aimée ; Ndjang Kombou, Doline ; Tsigaing, Philippe Narcisse ; Mbunka Awolu, Muhamed ; Seuleu Ndjamakou, Leticia Grace ; Sitamze Kaptue, Narcisse ; Ngounou Moyo, Dany Flora ; Patouokoumche Ngouh, Raimatou ; Kouotou Mouliom, Joseph Stéphane ; Abogo Abatsong, Henriette Alida ; Essebe Ngangue, Rose Cynthia ; Djeumene, Rodrigue ; Maguia Tatiane Kouam, Laure Tatiane ; Nono Djilo, Lydie Flore ; Bakmano Raïssa, Marie-Josée ; Njikeh, Kong Derick ; Bissek, Anne-Cécile ; Arinaitwe, Rinah ; Otai, David ; Kamanzi, Hamidah ; Natukunda, Agnes ; Natukunda, Eva ; Kyarimpa, Rose ; Kyomuhendo, Doreen ; Sanyu, Scovia ; Ssemanya, John ; Nabbuto, Jane ; Lugoose, Ssuan ; Rachael, Kiconco ; Tebylwa Beryta, Jonanita ; Kitakule, Frank ; Atuhaire, Syson ; Kembabazi, Moreen ; Abok, Florence ; Kakinda, Michael ; Odongo, Dickens ; Ijjo, Henri ; Kyomugisha, Clemencia ; Aryatuhwera, Johnan ; Ashaba, Beth ; Nuwamanya, Patrick ; Arinaitwe, Merdard ; Natukunda, Prisca ; Muhangi, Collins ; Muhumuza, Deogratious ; Ndyeimuka, Gordon ; Bagabe, Johnson ; Tiboruhanga, Justus ; Tibaijuka, Francis ; Nahabwe, Marion</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-5dc4fd765150228483e55875d784e64ec3d021b637a7fca7a60e441599a0c30c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Cameroon - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>HIV Infections</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Tuberculosis - diagnosis</topic><topic>Tuberculosis - drug therapy</topic><topic>Tuberculosis - prevention & control</topic><topic>Tuberculosis, Pulmonary - diagnosis</topic><topic>Tuberculosis, Pulmonary - drug therapy</topic><topic>Tuberculosis, Pulmonary - prevention & control</topic><topic>Uganda - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bonnet, Maryline</creatorcontrib><creatorcontrib>Vasiliu, Anca</creatorcontrib><creatorcontrib>Tchounga, Boris K</creatorcontrib><creatorcontrib>Cuer, Benjamin</creatorcontrib><creatorcontrib>Fielding, Katherine</creatorcontrib><creatorcontrib>Ssekyanzi, Bob</creatorcontrib><creatorcontrib>Tchakounte Youngui, Boris</creatorcontrib><creatorcontrib>Cohn, Jennifer</creatorcontrib><creatorcontrib>Dodd, Peter J</creatorcontrib><creatorcontrib>Tiendrebeogo, Georges</creatorcontrib><creatorcontrib>Tchendjou, Patrice</creatorcontrib><creatorcontrib>Simo, Leonie</creatorcontrib><creatorcontrib>Okello, Richard F</creatorcontrib><creatorcontrib>Kuate Kuate, Albert</creatorcontrib><creatorcontrib>Turyahabwe, Stavia</creatorcontrib><creatorcontrib>Atwine, Daniel</creatorcontrib><creatorcontrib>Graham, Stephen M</creatorcontrib><creatorcontrib>Casenghi, Martina</creatorcontrib><creatorcontrib>Chauvet, Savine</creatorcontrib><creatorcontrib>de Carvalho, Elisabete</creatorcontrib><creatorcontrib>Ouedraogo, Sayouba</creatorcontrib><creatorcontrib>Leguicher, Gwenvael</creatorcontrib><creatorcontrib>Tiam, Appolinaire</creatorcontrib><creatorcontrib>Oziemkowska, Maria</creatorcontrib><creatorcontrib>Atieno Ayuo, Elizabeth</creatorcontrib><creatorcontrib>Mafirakureva, Nyashadzaishe</creatorcontrib><creatorcontrib>Berset, Maude</creatorcontrib><creatorcontrib>Lemaire, Jean-Francois</creatorcontrib><creatorcontrib>Sih, Collette</creatorcontrib><creatorcontrib>Kana, Rogacien</creatorcontrib><creatorcontrib>Youm, Eric</creatorcontrib><creatorcontrib>Guedem Nekame, Jinette Lorraine</creatorcontrib><creatorcontrib>Manguele, Paul Williams</creatorcontrib><creatorcontrib>Bindzi, Paul</creatorcontrib><creatorcontrib>Ndongo, Marie-Louise Aimée</creatorcontrib><creatorcontrib>Ndjang Kombou, Doline</creatorcontrib><creatorcontrib>Tsigaing, Philippe Narcisse</creatorcontrib><creatorcontrib>Mbunka Awolu, Muhamed</creatorcontrib><creatorcontrib>Seuleu Ndjamakou, Leticia Grace</creatorcontrib><creatorcontrib>Sitamze Kaptue, Narcisse</creatorcontrib><creatorcontrib>Ngounou Moyo, Dany Flora</creatorcontrib><creatorcontrib>Patouokoumche Ngouh, Raimatou</creatorcontrib><creatorcontrib>Kouotou Mouliom, Joseph Stéphane</creatorcontrib><creatorcontrib>Abogo Abatsong, Henriette Alida</creatorcontrib><creatorcontrib>Essebe Ngangue, Rose Cynthia</creatorcontrib><creatorcontrib>Djeumene, Rodrigue</creatorcontrib><creatorcontrib>Maguia Tatiane Kouam, Laure Tatiane</creatorcontrib><creatorcontrib>Nono Djilo, Lydie Flore</creatorcontrib><creatorcontrib>Bakmano Raïssa, Marie-Josée</creatorcontrib><creatorcontrib>Njikeh, Kong Derick</creatorcontrib><creatorcontrib>Bissek, Anne-Cécile</creatorcontrib><creatorcontrib>Arinaitwe, Rinah</creatorcontrib><creatorcontrib>Otai, David</creatorcontrib><creatorcontrib>Kamanzi, Hamidah</creatorcontrib><creatorcontrib>Natukunda, Agnes</creatorcontrib><creatorcontrib>Natukunda, Eva</creatorcontrib><creatorcontrib>Kyarimpa, Rose</creatorcontrib><creatorcontrib>Kyomuhendo, Doreen</creatorcontrib><creatorcontrib>Sanyu, Scovia</creatorcontrib><creatorcontrib>Ssemanya, John</creatorcontrib><creatorcontrib>Nabbuto, Jane</creatorcontrib><creatorcontrib>Lugoose, Ssuan</creatorcontrib><creatorcontrib>Rachael, Kiconco</creatorcontrib><creatorcontrib>Tebylwa Beryta, Jonanita</creatorcontrib><creatorcontrib>Kitakule, Frank</creatorcontrib><creatorcontrib>Atuhaire, Syson</creatorcontrib><creatorcontrib>Kembabazi, Moreen</creatorcontrib><creatorcontrib>Abok, Florence</creatorcontrib><creatorcontrib>Kakinda, Michael</creatorcontrib><creatorcontrib>Odongo, Dickens</creatorcontrib><creatorcontrib>Ijjo, Henri</creatorcontrib><creatorcontrib>Kyomugisha, Clemencia</creatorcontrib><creatorcontrib>Aryatuhwera, Johnan</creatorcontrib><creatorcontrib>Ashaba, Beth</creatorcontrib><creatorcontrib>Nuwamanya, Patrick</creatorcontrib><creatorcontrib>Arinaitwe, Merdard</creatorcontrib><creatorcontrib>Natukunda, Prisca</creatorcontrib><creatorcontrib>Muhangi, Collins</creatorcontrib><creatorcontrib>Muhumuza, Deogratious</creatorcontrib><creatorcontrib>Ndyeimuka, Gordon</creatorcontrib><creatorcontrib>Bagabe, Johnson</creatorcontrib><creatorcontrib>Tiboruhanga, Justus</creatorcontrib><creatorcontrib>Tibaijuka, Francis</creatorcontrib><creatorcontrib>Nahabwe, Marion</creatorcontrib><creatorcontrib>CONTACT study group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet global health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bonnet, Maryline</au><au>Vasiliu, Anca</au><au>Tchounga, Boris K</au><au>Cuer, Benjamin</au><au>Fielding, Katherine</au><au>Ssekyanzi, Bob</au><au>Tchakounte Youngui, Boris</au><au>Cohn, Jennifer</au><au>Dodd, Peter J</au><au>Tiendrebeogo, Georges</au><au>Tchendjou, Patrice</au><au>Simo, Leonie</au><au>Okello, Richard F</au><au>Kuate Kuate, Albert</au><au>Turyahabwe, Stavia</au><au>Atwine, Daniel</au><au>Graham, Stephen M</au><au>Casenghi, Martina</au><au>Chauvet, Savine</au><au>de Carvalho, Elisabete</au><au>Ouedraogo, Sayouba</au><au>Leguicher, Gwenvael</au><au>Tiam, Appolinaire</au><au>Oziemkowska, Maria</au><au>Atieno Ayuo, Elizabeth</au><au>Mafirakureva, Nyashadzaishe</au><au>Berset, Maude</au><au>Lemaire, Jean-Francois</au><au>Sih, Collette</au><au>Kana, Rogacien</au><au>Youm, Eric</au><au>Guedem Nekame, Jinette Lorraine</au><au>Manguele, Paul Williams</au><au>Bindzi, Paul</au><au>Ndongo, Marie-Louise Aimée</au><au>Ndjang Kombou, Doline</au><au>Tsigaing, Philippe Narcisse</au><au>Mbunka Awolu, Muhamed</au><au>Seuleu Ndjamakou, Leticia Grace</au><au>Sitamze Kaptue, Narcisse</au><au>Ngounou Moyo, Dany Flora</au><au>Patouokoumche Ngouh, Raimatou</au><au>Kouotou Mouliom, Joseph Stéphane</au><au>Abogo Abatsong, Henriette Alida</au><au>Essebe Ngangue, Rose Cynthia</au><au>Djeumene, Rodrigue</au><au>Maguia Tatiane Kouam, Laure Tatiane</au><au>Nono Djilo, Lydie Flore</au><au>Bakmano Raïssa, Marie-Josée</au><au>Njikeh, Kong Derick</au><au>Bissek, Anne-Cécile</au><au>Arinaitwe, Rinah</au><au>Otai, David</au><au>Kamanzi, Hamidah</au><au>Natukunda, Agnes</au><au>Natukunda, Eva</au><au>Kyarimpa, Rose</au><au>Kyomuhendo, Doreen</au><au>Sanyu, Scovia</au><au>Ssemanya, John</au><au>Nabbuto, Jane</au><au>Lugoose, Ssuan</au><au>Rachael, Kiconco</au><au>Tebylwa Beryta, Jonanita</au><au>Kitakule, Frank</au><au>Atuhaire, Syson</au><au>Kembabazi, Moreen</au><au>Abok, Florence</au><au>Kakinda, Michael</au><au>Odongo, Dickens</au><au>Ijjo, Henri</au><au>Kyomugisha, Clemencia</au><au>Aryatuhwera, Johnan</au><au>Ashaba, Beth</au><au>Nuwamanya, Patrick</au><au>Arinaitwe, Merdard</au><au>Natukunda, Prisca</au><au>Muhangi, Collins</au><au>Muhumuza, Deogratious</au><au>Ndyeimuka, Gordon</au><au>Bagabe, Johnson</au><au>Tiboruhanga, Justus</au><au>Tibaijuka, Francis</au><au>Nahabwe, Marion</au><aucorp>CONTACT study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial</atitle><jtitle>The Lancet global health</jtitle><addtitle>Lancet Glob Health</addtitle><date>2023-12</date><risdate>2023</risdate><volume>11</volume><issue>12</issue><spage>e1911</spage><epage>e1921</epage><pages>e1911-e1921</pages><issn>2214-109X</issn><eissn>2214-109X</eissn><abstract>Globally, the uptake of tuberculosis-preventive treatment (TPT) among children with household tuberculosis contact remains low, partly due to the necessity of bringing children to health facilities for investigations. This study aimed to evaluate the effect on TPT initiation and completion of community-based approaches to tuberculosis contact investigations in Cameroon and Uganda.
We did a parallel, cluster-randomised, controlled trial across 20 clusters (consisting of 25 district hospitals and primary health centres) in Cameroon and Uganda, which were randomised (1:1) to receive a community-based approach (intervention group) or standard-of-care facility-based approach to contact screening and management (control group). The community-based approach consisted of symptom-based tuberculosis screening of all household contacts by community health workers at the household, with referral of symptomatic contacts to local facilities for investigations. Initiation of TPT (3-month course of rifampicin–isoniazid) was done by a nurse in the household, and home visits for TPT follow-up were done by community health workers. Index patients were people aged 15 years or older with bacteriologically confirmed, drug-susceptible, pulmonary tuberculosis diagnosed less than 1 month before inclusion and who declared at least one child or young adolescent (aged 0–14 years) household contact. The primary endpoint was the proportion of declared child contacts in the TPT target group (those aged <5 years irrespective of HIV status, and children aged 5–14 years living with HIV) who commenced and completed TPT, assessed in the modified intention-to-treat population (excluding enrolled index patients and their contacts who did not fit the eligibility criteria). Descriptive cascade of care assessment and generalised linear mixed modelling were used for comparison. This study is registered with ClinicalTrials.gov (NCT03832023).
The study included nine clusters in the intervention group (after excluding one cluster that did not enrol any index patients for >2 months) and ten in the control group. Between Oct 14, 2019 and Jan 13, 2022, 2894 child contacts were declared by 899 index patients with bacteriologically confirmed tuberculosis. Among all child contacts declared, 1548 (81·9%) of 1889 in the intervention group and 475 (47·3%) of 1005 in the control group were screened for tuberculosis. 1400 (48·4%) child contacts were considered to be in the TPT target group: 941 (49·8%) of 1889 in the intervention group and 459 (45·7%) of 1005 in the control group. In the TPT target group, TPT was commenced and completed in 752 (79·9%) of 941 child contacts in the intervention group and 283 (61·7%) of 459 in the control group (odds ratio 3·06 [95% CI 1·24–7·53]).
A community-based approach using community health workers can significantly increase contact investigation coverage and TPT completion among eligible child contacts in a tuberculosis-endemic setting.
Unitaid.
For the French translation of the abstract see Supplementary Materials section.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37918417</pmid><doi>10.1016/S2214-109X(23)00430-8</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2214-109X |
| ispartof | The Lancet global health, 2023-12, Vol.11 (12), p.e1911-e1921 |
| issn | 2214-109X 2214-109X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2886331858 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Cameroon - epidemiology Child Child, Preschool HIV Infections Humans Infant Infant, Newborn Tuberculosis - diagnosis Tuberculosis - drug therapy Tuberculosis - prevention & control Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - prevention & control Uganda - epidemiology |
| title | Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T23%3A35%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effectiveness%20of%20a%20community-based%20approach%20for%20the%20investigation%20and%20management%20of%20children%20with%20household%20tuberculosis%20contact%20in%20Cameroon%20and%20Uganda:%20a%20cluster-randomised%20trial&rft.jtitle=The%20Lancet%20global%20health&rft.au=Bonnet,%20Maryline&rft.aucorp=CONTACT%20study%20group&rft.date=2023-12&rft.volume=11&rft.issue=12&rft.spage=e1911&rft.epage=e1921&rft.pages=e1911-e1921&rft.issn=2214-109X&rft.eissn=2214-109X&rft_id=info:doi/10.1016/S2214-109X(23)00430-8&rft_dat=%3Cproquest_cross%3E2886331858%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2886331858&rft_id=info:pmid/37918417&rft_els_id=S2214109X23004308&rfr_iscdi=true |