{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:37:46Z","timestamp":1787243866517,"version":"build-2736575974"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100032626","name":"UNITAID","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100032626","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009633","name":"NICHD","doi-asserted-by":"publisher","award":["K23HD096973"],"award-info":[{"award-number":["K23HD096973"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022513","name":"Ethiopian Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022513","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis preventive treatment (TPT) is highly effective at preventing tuberculosis (TB) disease but is poorly implemented. We aimed to determine whether home-based contact management improves TPT uptake among close child contacts compared to the facility-based standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pragmatic cluster-randomized trial among close contacts of TB clients aged &amp;lt;15 years in 18 primary health facilities in Oromia, Ethiopia. Facilities were randomized 1:1 to home-based or facility-based contact management. The intervention was conducted by community health workers (CHWs) and task-shared with TB focal persons. The primary endpoint was the cluster-level ratio of the number of contacts aged &amp;lt;15 years initiated on TPT per TB client.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cluster-level mean number of child contacts initiated on TPT per TB client was 40% higher in the home-based (1.7 contacts per TB client) versus facility-based arm (1.3 contacts per TB client; rate ratio 1.4, 95% confidence interval [CI]: .7\u20132.7). In the care continuum, assuming 2.1 children &amp;lt;15 years per household, 73% and 63% of children completed TPT in the 2 arms, respectively. One child failed TPT and 2 children discontinued TPT due to drug-related adverse reactions in the home-based and facility-based arms, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Home-based contact management by CHWs increased the number of children initiated on TPT by 40% without negative effects on treatment outcomes. Though not statistically significant, on a larger scale, the increased number of children identified and initiated on TPT has the potential to substantially reduce the burden of pediatric TB in Ethiopia and elsewhere.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT04369326.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf203","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T07:51:46Z","timestamp":1747036306000},"page":"e385-e392","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of a Home-based Approach to Child Contact Investigation and Tuberculosis Preventive Treatment Management by Community Health Workers in Ethiopia: A Pragmatic Cluster-randomized Trial"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9875-9319","authenticated-orcid":false,"given":"Nicole","family":"Salazar-Austin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cohn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-7487","authenticated-orcid":false,"given":"Bareng A S","family":"Nonyane","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2628-7460","authenticated-orcid":false,"given":"Christiaan","family":"Mulder","sequence":"additional","affiliation":[{"name":"Tuberculosis Elimination and Health Systems Innovations, KNCV Tuberculosis Foundation , The Hague ,","place":["The Netherlands"]},{"name":"Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centres , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiseha","family":"Mulatu","sequence":"additional","affiliation":[{"name":"KNCV Ethiopia , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Bayu","sequence":"additional","affiliation":[{"name":"KNCV Ethiopia , Addis Ababa 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3499-5547","authenticated-orcid":false,"given":"Natalia Hernandez","family":"Morfin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Borsboom","sequence":"additional","affiliation":[{"name":"Tuberculosis Elimination and Health Systems Innovations, KNCV Tuberculosis Foundation , The Hague ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Mitiku","sequence":"additional","affiliation":[{"name":"KNCV Ethiopia , Addis Ababa 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