{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:04:03Z","timestamp":1792803843005,"version":"4.5.0"},"reference-count":35,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Resolve to Save Lives, New York, USA","award":["PRO221"],"award-info":[{"award-number":["PRO221"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,8]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A \u20187-1-7\u2019 timeliness metric, developed for hastening the response to infectious disease outbreaks\/pandemics, was adapted to improve screening and managing household contacts (HHCs) of pulmonary tuberculosis (TB) patients. The feasibility, enablers, challenges and utility of implementing this modified metric through TB Champions (TB survivors) for HHC management were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was an explanatory mixed-methods study with a cohort design (quantitative) followed by a descriptive design with focus group discussions (qualitative).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted within routine programmatic settings in public health facilities in six districts from three states of India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>In total, 595 drug-susceptible index pulmonary TB patients registered for treatment in the selected health facilities, and their listed 2108 HHCs were included in the study between December 2022 and August 2023. All 17 TB Champions involved in implementation participated in the focus group discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome measures were the percentage of eligible participants receiving the desired service within the \u20187-1-7\u2019 timeliness metric and challenges in achieving the timeliness metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 89% of 595 index patients, their HHCs were line-listed within 7\u2009days of initiating anti-TB treatment (\u2018First-7\u2019). In 90% of 2108 HHCs, screening outcomes were ascertained within 1\u2009day of line-listing (\u2018Next-1\u2019). In 42% of 2073 HHCs eligible for further evaluation, anti-TB treatment, TB preventive treatment (TPT) or a decision to not receive medication were made within 7\u2009days of screening (\u2018Second-7\u2019). Barriers to TPT uptake included lack of money and daily wage losses for travelling to clinics, reluctance of asymptomatic contacts to take medication and fear of adverse events. TB Champions felt timeliness metrics improved performance in the systematic and timely management of HHCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TB Champions found \u20187-1-7\u2019 timeliness metrics were feasible and useful, and national TB programmes should consider their operationalisation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097935","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T13:43:21Z","timestamp":1762263801000},"page":"e097935","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Implementing timeliness metrics for household contact tracing and TB preventive treatment through TB champions in the public sector, India: an explanatory mixed-methods study"],"prefix":"10.1136","volume":"15","author":[{"given":"Divya","family":"Nair","sequence":"first","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pruthu","family":"Thekkur","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeswaran","family":"Thiagesan","sequence":"additional","affiliation":[{"name":"Resource Group for Education and Advocacy for Community Health, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashvini","family":"Vyas","sequence":"additional","affiliation":[{"name":"Resource Group for Education and Advocacy for Community Health, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchismita","family":"Paul","sequence":"additional","affiliation":[{"name":"Resource Group for Education and Advocacy for Community Health, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal Krishna","family":"Mishra","sequence":"additional","affiliation":[{"name":"State TB Cell, Government of Bihar State Health Society, Patna, BR, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanta Kumar","family":"Hota","sequence":"additional","affiliation":[{"name":"TB Health Services, Directorate of Public Health Odisha, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Khogali","sequence":"additional","affiliation":[{"name":"Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2915-9328","authenticated-orcid":false,"given":"Rony","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma Dar","family":"Berger","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5420-2551","authenticated-orcid":false,"given":"Srinath","family":"Satyanarayana","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"},{"name":"Centre for Operational Research, The Union South-East Asia Office, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay M V","family":"Kumar","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"},{"name":"Centre for Operational Research, The Union South-East Asia Office, New Delhi, India"},{"name":"Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, KA, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron F","family":"Bochner","sequence":"additional","affiliation":[{"name":"Resolve to Saves Lives, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Ananthakrishnan","sequence":"additional","affiliation":[{"name":"Resource Group for Education and Advocacy for Community Health, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6113-9741","authenticated-orcid":false,"given":"Anthony D","family":"Harries","sequence":"additional","affiliation":[{"name":"Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France"},{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine Faculty of Infectious and Tropical Diseases, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"2025120413251926000_15.11.e097935.1","unstructured":"Global tuberculosis report 2024. 2025. 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