{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:55:11Z","timestamp":1773413711109,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The duration of infectiousness following pulmonary tuberculosis treatment initiation remains uncertain. We aimed to assess whether a bundled intervention designed to decrease respiratory exposure was feasible and would reduce new tuberculosis infections in household contacts (HHCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pilot cluster-randomized controlled trial with a hybrid type 1 effectiveness-implementation design in Santiago, Chile. Random allocation was performed, and 2 healthcare districts were assigned to the intervention (n = 180 HHCs) and 1 to standard of care (n = 149 HHCs). Eligible participants were people newly diagnosed with pulmonary tuberculosis and their HHCs. The intervention included education, mask use, household ventilation, and nightly separation of tuberculosis patients, for 2 weeks. Intervention adherence was evaluated weekly. Effectiveness was assessed at the individual level with QuantiFERON\u00ae-TB Gold Plus (QFT) test conversions in HHCs at 12-week follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between October 2021 and December 2023, 384 HHCs and 157 people with tuberculosis were enrolled. Overall, 56.3% of contacts were women, with a mean age of 34.6 years and a baseline QFT positivity of 32.3%. A total of 216 contacts had negative QFT result at baseline, with 179 (82.9%) completing follow-up. QuantiFERON\u00ae-TB Gold Plus conversions occurred in 11 (12.8%) and 10 (10.8%) HHCs from the intervention and control arms, respectively (incidence risk ratio 1.10, 95% CI .71\u20131.71, P = .849). Good adherence to the respiratory bundle was reported by 53% of participants on day 7 and 54% on day 14.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Isolation and restrictive measures after tuberculosis treatment initiation proved challenging and did not reduce tuberculosis infections in HHCs, suggesting limited benefit for transmission control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf526","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T11:53:55Z","timestamp":1758628435000},"page":"291-298","source":"Crossref","is-referenced-by-count":0,"title":["Reducing Household Tuberculosis Transmission: A Pilot Cluster-Randomized Controlled Trial"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4712-3302","authenticated-orcid":false,"given":"Cinthya","family":"Ruiz-Tagle","sequence":"first","affiliation":[{"name":"Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romina","family":"Seguel","sequence":"additional","affiliation":[{"name":"Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9603-937X","authenticated-orcid":false,"given":"Luis","family":"Villarroel","sequence":"additional","affiliation":[{"name":"Departamento de Salud P\u00fablica, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-8927","authenticated-orcid":false,"given":"Margarita","family":"Bernales","sequence":"additional","affiliation":[{"name":"Escuela de Enfermer\u00eda, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1277-0232","authenticated-orcid":false,"given":"Salvador","family":"Vargas-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6612-1011","authenticated-orcid":false,"given":"Alejandra","family":"Pizarro","sequence":"additional","affiliation":[{"name":"Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Borja Arriar\u00e1n, Unidad Broncopulmonar , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edctor","family":"Neira","sequence":"additional","affiliation":[{"name":"Programa de Tuberculosis, Servicio de Salud Metropolitano Norte , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5983-2392","authenticated-orcid":false,"given":"Patricia","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Departamento de Laboratorios Cl\u00ednicos, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-7181","authenticated-orcid":false,"given":"Kasim","family":"Allel","sequence":"additional","affiliation":[{"name":"Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile , Santiago ,","place":["Chile"]},{"name":"Health Economics and Policy Evaluation Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford , Oxford ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3544-5021","authenticated-orcid":false,"given":"Ruvandhi R","family":"Nathavitharana","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts 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