{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:27:00Z","timestamp":1791563220907,"version":"4.3.4"},"reference-count":31,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["Contract No. 19\/897"],"award-info":[{"award-number":["Contract No. 19\/897"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2025,7,23]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In high tuberculosis (TB)-burden countries, considerable transmission of <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (<jats:italic>M. tb<\/jats:italic>) likely occurs outside of households. We aimed to estimate the TB prevalence and incidence in households and neighbourhoods around known TB cases and to understand transmission patterns.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Household and neighbourhood contacts of pulmonary TB index cases from contiguous areas in Bandung, Indonesia, were screened and followed up for 12 months. Sputum samples underwent smear microscopy, <jats:italic>M. tb<\/jats:italic> culture, Xpert MTB\/RIF, DNA isolation and whole-genome sequencing (WGS). Pairwise single-nucleotide polymorphism (SNP) distance \u226412 defined transmission for pairs with known epidemiological links, or SNP\u22643 for pairs without epidemiological link. An SNP=12 cut-off was used to characterise transmission clusters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 213 index cases, 514 household and 4141 neighbourhood contacts underwent TB screening: 19 household (3.70%, 95%\u2009CI 2.24 to 5.71) and 45 neighbourhood (1.09%, 95%\u2009CI 0.79 to 1.45) contacts were identified with TB, of whom 18 (3.50%, 95%\u2009CI 2.20 to 5.48) and 38 (0.92%, 95%\u2009CI 0.65 to 1.13) respectively, were bacteriologically confirmed. During follow-up, 11 household and 13 neighbourhood contacts were identified with TB (incidence per 100\u2009000 person-years: 2286 (95% CI 1286 to 4148) and 350 (95% CI 190 to 563)), of whom 6 and 8, respectively, were bacteriologically confirmed (incidence per 100\u2009000 person-years: 1247 (95% CI 560 to 2776) and 201 (95% CI 101 to 402)). A total of 223 patient <jats:italic>M. tb<\/jats:italic> isolates underwent WGS. Of 15 intra-household pairs, 8 (53.3%) were transmission pairs. Of 24 neighbour to index case pairs, 1 (4.2%) was a transmission pair. 11 of 19 transmission pairs shared no epidemiological link. We identified 25 <jats:italic>M<\/jats:italic>. <jats:italic>tb<\/jats:italic> genetic clusters from 205 mono-TB isolates overall.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Neighbours have lower prevalence and incidence of TB than household contacts, but twice as many cases. Very few received <jats:italic>M. tb<\/jats:italic> from their index case, suggesting uncontrolled community-wide transmission. Whole population active case finding may be necessary in high TB-burden settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgh-2025-019137","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T04:50:22Z","timestamp":1758603022000},"page":"e019137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Should neighbours of tuberculosis (TB) cases be prioritised for active case finding in high TB-burden settings? A prospective molecular epidemiological study"],"prefix":"10.1136","volume":"10","author":[{"given":"Raspati C","family":"Koesoemadinata","sequence":"first","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7881-6622","authenticated-orcid":false,"given":"Susan","family":"McAllister","sequence":"additional","affiliation":[{"name":"Centre for International Health, University of Otago Division of Health Sciences, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Chin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard University, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri","family":"Hartati","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanif","family":"Djunaedy","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nury Fitri","family":"Dewi","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidya","family":"Chaidir","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"},{"name":"Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bony Wiem","family":"Lestari","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"},{"name":"Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panji Fortuna","family":"Hadisoemarto","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"},{"name":"Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinout","family":"Van Crevel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan B","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bachti","family":"Alisjahbana","sequence":"additional","affiliation":[{"name":"Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia"},{"name":"Hasan Sadikin Hospital, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip C","family":"Hill","sequence":"additional","affiliation":[{"name":"Centre for International Health, University of Otago Division of Health Sciences, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"2025092221501448000_10.9.e019137.1","unstructured":"World Health Organization . Global tuberculosis report 2024. Contract no.: Licence: CC BY-NC-SA 3.0 IGO. Geneva World Health Organization; 2024."},{"key":"2025092221501448000_10.9.e019137.2","unstructured":"World Health Organization . Tuberculosis profile: Indonesia. 2022. Available: https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/?_inputs_&entity_type=%22country%22&iso2=%22ID%22&lan=%22EN%22 [Accessed 25 Nov 2024]."},{"key":"2025092221501448000_10.9.e019137.3","unstructured":"Kementerian Kesehatan Republic Indonesia . Direktorat Jenderal Pencegahan dan Pengendalian Kementerian Kesehatan Republik Indonesia Petunjuk Teknis Investigasi Kontak Pasien TBC Bagi Petugas Kesehata Dan Kadar. Jakarta, Indonesia, 2019."},{"key":"2025092221501448000_10.9.e019137.4","unstructured":"World Health Organization . WHO consolidated guidelines on tuberculosis. Module 2: screening - systematic screening for tuberculosis disease. 2021."},{"key":"2025092221501448000_10.9.e019137.5","unstructured":"Ministry of Health of the Republic of Indonesia . TB Indonesia 2022. Available: https:\/\/tbindonesia.or.id\/ [Accessed 06 Jul 2024]."},{"key":"2025092221501448000_10.9.e019137.6","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00266-2021"},{"key":"2025092221501448000_10.9.e019137.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1902129"},{"key":"2025092221501448000_10.9.e019137.8","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx025"},{"key":"2025092221501448000_10.9.e019137.9","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.3201\/eid2605.191568","article-title":"A Neighbor-Based Approach to Identify Tuberculosis Exposure, the Kopanyo Study","volume":"26","author":"Moonan","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"2025092221501448000_10.9.e019137.10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.5588\/pha.17.0026","article-title":"Feasibility of two active case finding approaches for detection of tuberculosis in Bandung City, Indonesia","volume":"7","author":"McAllister","year":"2017","journal-title":"Public Health Action"},{"key":"2025092221501448000_10.9.e019137.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2011.02869.x"},{"key":"2025092221501448000_10.9.e019137.12","doi-asserted-by":"crossref","DOI":"10.1186\/s40249-020-00766-4","article-title":"Evaluating the yield of systematic screening for tuberculosis among three priority groups in Ho Chi Minh City, Viet Nam","volume":"9","author":"Vo","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"2025092221501448000_10.9.e019137.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0209290","article-title":"Optimizing community screening for tuberculosis: Spatial analysis of localized case finding from door-to-door screening for TB in an urban district of Ho Chi Minh City, Viet Nam","volume":"13","author":"Vo","year":"2018","journal-title":"PLoS ONE"},{"key":"2025092221501448000_10.9.e019137.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165813","article-title":"Extending \u201cContact Tracing\u201d into the Community within a 50-Metre Radius of an Index Tuberculosis Patient Using Xpert MTB\/RIF in Urban, Pakistan: Did It Increase Case Detection?","volume":"11","author":"Fatima","year":"2016","journal-title":"PLoS One"},{"key":"2025092221501448000_10.9.e019137.15","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1275140","article-title":"Finding and treating both tuberculosis disease and latent infection during population-wide active case finding for tuberculosis elimination","volume":"10","author":"Coleman","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"2025092221501448000_10.9.e019137.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0256043","article-title":"Are neighbourhoods of tuberculosis cases a high-risk population for active intervention? 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Asymptomatic tuberculosis and implications for programmatic action. 2025. Available: https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2024\/featured-topics\/asymptomatic-tb [Accessed 10 Apr 2025]."},{"key":"2025092221501448000_10.9.e019137.26","unstructured":"Ministry of Health Indonesia . National TB prevalence survey. 2014."},{"key":"2025092221501448000_10.9.e019137.27","doi-asserted-by":"crossref","DOI":"10.3390\/tropicalmed9020034","article-title":"The Yield of Active Tuberculosis Disease and Latent Tuberculosis Infection in Tuberculosis Household Contacts Investigated Using Chest X-ray in Yogyakarta Province, Indonesia","volume":"9","author":"Nababan","year":"2024","journal-title":"Trop Med Infect Dis"},{"key":"2025092221501448000_10.9.e019137.28","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00070812"},{"key":"2025092221501448000_10.9.e019137.29","article-title":"Genotypic and spatial analysis of transmission dynamics of tuberculosis in Shanghai, China: a 10-year prospective population-based surveillance study","volume":"38","author":"Li","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"key":"2025092221501448000_10.9.e019137.30","article-title":"Genomic epidemiology of tuberculosis in eastern Malaysia: insights for strengthening public health responses","volume":"7","author":"Bainomugisa","year":"2021","journal-title":"Microb Genom"},{"key":"2025092221501448000_10.9.e019137.31","first-page":"480","article-title":"Risk factors for clustering of tuberculosis cases: a systematic review of population-based molecular epidemiology studies","volume":"12","author":"Fok","year":"2008","journal-title":"Int J Tuberc Lung Dis"}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2025-019137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T04:50:26Z","timestamp":1758603026000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2025-019137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,22]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bmjgh-2025-019137"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2025-019137","relation":{},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}