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

作者：Maryline Bonnet, Anca Vasiliù, Boris Tchounga, Benjamin Cuer, Katherine Fielding, Bob Ssekyanzi, Boris Tchakounté Youngui, Jennifer Cohn, Peter J. Dodd, Georges Tiendrebéogo, Patrice Tchendjou, Leonie Simo, Richard F Okello, Albert Kuate Kuate, Stavia Turyahabwe, Daniel Atwine, Stephen M. Graham, Martina Casenghi, Savine Chauvet, Elisabete de Carvalho, Sayouba Ouedraogo, Gwenvael Leguicher, Appolinaire Tiam, Maria Oziemkowska, Elizabeth Atieno Ayuo, Nyashadzaishe Mafirakureva, Maude Berset, Jean-Francois Lemaire, Collette Sih, Rogacien Kana, Eric Youm, Jinette Lorraine Guedem Nekame, Paul Williams Manguele, Paul Bindzi, Marie-Louise Aimée Ndongo, Doline Ndjang Kombou, Philippe Narcisse Tsigaing, Muhamed Mbunka Awolu, Leticia Grace Seuleu Ndjamakou, Narcisse Sitamze Kaptue, Dany Flora Ngounou Moyo, Raimatou Patouokoumche Ngouh, Joseph Stéphane Kouotou Mouliom, Henriette Alida Abogo Abatsong, Rose Cynthia Essebe Ngangue, Rodrigue Djeumene, Laure Tatiane Maguia Tatiane Kouam, Lydie Flore Nono Djilo, Marie-Josée Bakmano Raïssa, Kong Derick Njikeh, Anne-Cécile Bissek, Rinah Arinaitwe, David Otai, Hamidah Kamanzi, Agnes Natukunda, Eva Natukunda, Rose Kyarimpa, Doreen Kyomuhendo, Scovia Sanyu, John Ssemanya, Jane Nabbuto, Ssuan Lugoose, Kiconco Rachael, Jonanita Tebylwa Beryta, Frank Kitakule, Syson Atuhaire, Moreen Kembabazi, Florence Abok, Michael Kakinda, Dickens Odongo, Henri Ijjo, Clemencia Kyomugisha, Johnan Aryatuhwera, Beth Ashaba, Patrick Nuwamanya, Merdard Arinaitwe, Prisca Natukunda, Collins Muhangi, Deogratious Muhumuza, Gordon Ndyeimuka, Johnson Bagabe, Justus Tiboruhanga, Francis Tibaijuka, Marion Nahabwe · 发表于：The Lancet Global Health · 年份：2023 · DOI：10.1016/s2214-109x(23)00430-8 · 被引用次数：40 · 研究领域：Tuberculosis Research and Epidemiology、Pneumonia and Respiratory Infections、Healthcare Facilities Design and Sustainability

BACKGROUND: 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. METHODS: 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 ...