{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:12:00Z","timestamp":1790647920274,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T00:00:00Z","timestamp":1640304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UK\/South Africa Medical Research Council (MRC) Newton Fund","award":["006Newton TB"],"award-info":[{"award-number":["006Newton TB"]}]},{"DOI":"10.13039\/100004440","name":"Wellcome","doi-asserted-by":"publisher","award":["200901\/Z\/16\/Z"],"award-info":[{"award-number":["200901\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"South African MRC and UK Government Newton Fund","award":["006Newton TB"],"award-info":[{"award-number":["006Newton TB"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Household contact tracing for tuberculosis (TB) may facilitate diagnosis and access to TB preventive treatment (TPT). We investigated whether household contact tracing and intensive TB\/human immunodeficiency virus (HIV) screening would improve TB-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Household contacts of index TB patients in 2 South African provinces were randomized to home tracing and intensive HIV\/TB screening or standard of care (SOC; clinic referral letters). The primary outcome was incident TB or death at 15 months. Secondary outcomes included tuberculin skin test (TST) positivity in children \u226414 years and undiagnosed HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From December 2016 through March 2019, 1032 index patients (4459 contacts) and 1030 (4129 contacts) were randomized to the intervention and SOC arms. Of intervention arm contacts, 3.2% (69 of 2166) had prevalent microbiologically confirmed TB. At 15 months, the cumulative incidence of TB or death did not differ between the intensive screening (93 of 3230, 2.9%) and SOC (80 of 2600, 3.1%) arms (hazard ratio, 0.90; 95% confidence interval [CI], .66\u20131.24). TST positivity was higher in the intensive screening arm (38 of 845, 4.5%) compared with the SOC arm (15 of 800, 1.9%; odds ratio, 2.25; 95% CI, 1.07\u20134.72). Undiagnosed HIV was similar between arms (41 of 3185, 1.3% vs 32 of 2543, 1.3%; odds ratio, 1.02; 95% CI, .64\u20131.64).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Household contact tracing with intensive screening and referral did not reduce incident TB or death. Providing referral letters to household contacts of index patients is an alternative strategy to home visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>ISRCTN16006202.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab1047","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T15:13:02Z","timestamp":1640185982000},"page":"849-856","source":"Crossref","is-referenced-by-count":25,"title":["Household Contact Tracing With Intensified Tuberculosis and Human Immunodeficiency Virus Screening in South Africa: A Cluster-Randomized Trial"],"prefix":"10.1093","volume":"75","author":[{"given":"Neil A","family":"Martinson","sequence":"first","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"Center for Tuberculosis Research, Johns Hopkins University , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limakatso","family":"Lebina","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L","family":"Webb","sequence":"additional","affiliation":[{"name":"Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ratsela","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Limpopo , Polokwane , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrahim","family":"Varavia","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"Department of Internal Medicine, Klerksdorp Tshepong Hospital Complex, North West Provincial Department of Health, and University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Kinghorn","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay G","family":"Lala","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"Department of Paediatrics and Child Health, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E","family":"Golub","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis Research, Johns Hopkins University , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zama","family":"Bosch","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kegaugetswe P","family":"Motsomi","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-9613","authenticated-orcid":false,"given":"Peter","family":"MacPherson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine , Liverpool , United Kingdom"},{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme , Blantyre , Malawi"},{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine , London , United 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