Are neighbourhoods of tuberculosis cases a high-risk population for active intervention? A protocol for tuberculosis active case finding

• Published in: PloS one 2021-08, Vol.16 (8), p.e0256043-e0256043
• Main Authors: Alisjahbana, Bachti, Koesoemadinata, Raspati Cundarani, Hadisoemarto, Panji Fortuna, Lestari, Bony Wiem, Hartati, Sri, Chaidir, Lidya, Huang, Chuan-Chin, Murray, Megan, Hill, Philip Campbell, McAllister, Susan Margaret
• Format: Article
• Language: English
• Subjects: Analysis; Biology and Life Sciences; Computer and Information Sciences; Consent; Contact Tracing - methods; Cough; Cough - diagnosis; Cough - microbiology; Diagnosis; Disease prevention; Disease transmission; Disease Transmission, Infectious - prevention & control; Epidemiologic Research Design; Epidemiology; Evaluation; Feasibility studies; Gene sequencing; Health risks; Health sciences; Hospitals; Households; Humans; Indonesia - epidemiology; Infectious diseases; Internal medicine; Intervention; Medical diagnosis; Medical schools; Medicine; Medicine and Health Sciences; Microbiological analysis; Mycobacterium tuberculosis - isolation & purification; Mycobacterium tuberculosis - pathogenicity; Neighborhoods; Network analysis; People and Places; Population; Prevalence; Prevalence studies (Epidemiology); Public health; Radiography - methods; Risk Factors; Signs and symptoms; Social networks; Social organization; Social Sciences; Sociodemographics; Sputum; Study Protocol; Supervision; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Tuberculosis - microbiology; Tuberculosis - transmission; Urban areas; Urban environments; Whole genome sequencing; Whole Genome Sequencing - methods
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256043

Indonesia has the second largest tuberculosis (TB) burden globally. Attempts to scale-up TB control efforts have focused on TB households. However, in most high burden settings, considerable Mycobacterium tuberculosis (Mtb) transmission occurs outside TB households. A better understanding of transmission dynamics in an urban setting in Indonesia will be crucial for the TB Control Program in scaling up efforts towards elimination of TB in a more targeted way. Therefore, the study aims to measure TB prevalence and incidence in household contacts and neighbourhoods in the vicinity of known TB cases and to assess their genomic and epidemiological relatedness. Individuals (~1000) living in the same household as a case diagnosed with pulmonary TB (n = 250) or in a neighbouring household (~4500 individuals) will be screened for TB symptoms and by chest x-ray. Two sputum samples will be collected for microbiological analysis from anyone with a productive cough. Any person found to have TB will be treated by the National TB Control Program. All those with no evidence of TB disease will have a repeat screen at 12 months. Whole-genome sequencing (WGS) and social network analysis (SNA) will be conducted on Index cases and contacts diagnosed with TB.