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| ID | Type | Description | Link |
|---|---|---|---|
| 5R01AI104824 | U.S. NIH Grant/Contract | View source | |
| R01AI104824 | U.S. NIH Grant/Contract | View source | |
| 2000023199 | Other Identifier | Yale IRB |
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| Name | Class |
|---|---|
| National Institute of Allergy and Infectious Diseases (NIAID) | NIH |
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In a previous randomized control trial, the investigators identified gaps in the implementation of tuberculosis (TB) contact investigation at multiple levels of the service delivery cascade. Drawing on prior experiences, the investigators have recently developed a novel strategy to enhance the implementation of routine contact investigation procedures. This user-centered implementation strategy was created through serial prototyping guided by human-centered design (HCD) and employs communities of practice (CoP) as an adjunctive adaptation and sustainment strategy. The investigators are now conducting a stepped-wedge, cluster-randomized implementation trial in 12 study sites in Uganda to determine if the resulting user-centered implementation strategy enhances the delivery of TB contact investigation and other implementation outcomes, and also improves health outcomes.
The trial has 3 major aims: (1) to compare the implementation, effectiveness, and public health impact of TB contact investigation delivered via an enhanced, "user-centered" implementation strategy versus a standard implementation strategy in a stepped-wedge, cluster-randomized implementation trial; (2) to identify processes and contextual factors that influence the implementation, effectiveness, and public health impact of the enhanced delivery strategy for TB contact investigation; and (3) to compare the costs and epidemiological impact of the enhanced and standard implementation strategies for TB contact investigation. The enhanced, user-centered strategy will employ two major components: a) a branded, participant-centered strategy consisting of implementation facilitation tools previously developed using human-centered design; and b) Communities of Practice, a community-health worker-centered, continuous quality improvement strategy. The goal is to improve the delivery of standard TB contact investigation following Uganda National TB & Leprosy Programme guidelines. The investigators hypothesize that the enhanced, user-centered strategy will result in a greater proportion of close contacts completing TB evaluation than the standard strategy. They further hypothesize that successful implementation will be deemed feasible, acceptable, and appropriate by patients and CHWs and that it will increase self-efficacy and perceived social support among CHWs. Finally, the investigators hypothesize that models evaluating the impact of the user-centered strategy when delivered nationwide will find it cost-effective and able to reduce national TB incidence over a 10-year horizon.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Implementation Strategy Period | Active Comparator | During the standard implementation strategy period, CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
|
| Enhanced Contact Investigation Intervention Period | Experimental | The enhanced contact investigation strategy includes 4 implementation facilitation tools and 3 continuous quality improvement techniques and will be delivered as a branded package named for an inspirational Luganda phrase that is translated as "We are together with you." Implementation facilitation tools include 1) a TB education pamphlet, 2) a contact identification algorithm, 3) an instructional video on sputum collection, and 4) community health riders who transport clients, community health workers, and sputum samples by motorcycle. The continuous quality improvement techniques delivered as the community of practice package include 1) community of practice meetings, 2) audit and feedback reports and 3) a group chat application. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| User-Centered Implementation Strategy | Behavioral |
|
| Measure | Description | Time Frame |
|---|---|---|
| Completion of TB Evaluation | The percentage of participants (close contacts) who are experiencing TB symptoms who complete TB evaluation within 60 days of the TB patient's treatment initiation date | 60 days |
| Measure | Description | Time Frame |
|---|---|---|
| TB Yield (Diagnosis and Treatment Initiation) | The difference between study periods in percentage of contacts diagnosed with active TB and initiated on treatment within 60 days of the TB patient's treatment initiation | 60 days |
| Initiation of TB Preventative Therapy |
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Health centre inclusion criteria:
Health centre exclusion criteria:
1) Administrators of the health centre do not agree to participate in the study
Individual inclusion criteria for index persons with TB (also known as index TB patients or TB cases):
Individual exclusion criteria for index persons with TB :
Inclusion criteria for close contacts:
1) Being an adult or child reporting ≥12 cumulative hours with the TB patient inside an enclosed space within the previous 3 months,
Exclusion criteria for close contacts:
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| Name | Affiliation | Role |
|---|---|---|
| J. Lucian Davis, MD | Yale School of Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uganda Tuberculosis Implementation Research Consortium | Kampala | Uganda |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37592314 | Derived | Katamba A, Gupta AJ, Turimumahoro P, Ochom E, Ggita JM, Nakasendwa S, Nanziri L, Musinguzi J, Hennein R, Sekadde M, Hanrahan C, Byaruhanga R, Yoeli E, Turyahabwe S, Cattamanchi A, Dowdy DW, Haberer JE, Armstrong-Hough M, Kiwanuka N, Davis JL. A user-centred implementation strategy for tuberculosis contact investigation in Uganda: protocol for a stepped-wedge, cluster-randomised trial. BMC Public Health. 2023 Aug 17;23(1):1568. doi: 10.1186/s12889-023-16510-0. | |
| 37461631 |
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All IPD that underlie results in a publication upon request
After primary trial results are published
Upon request to the PI
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In this stepped-wedge, cluster-randomized trial, 12 health facilities progress from Standard Contact Investigation [Control] to User-centered Contact Investigation [Intervention] in 6 clusters of randomly assigned pairs that cross over one cluster at a time [Sequences] at randomly assigned 8-week intervals [Periods]. All clusters start in Standard for 8 weeks, then 1 cluster crosses over to User-centered every 8 weeks for 48 weeks, and finally all clusters are in User-centered for 8 weeks.
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| ID | Title | Description |
|---|---|---|
| FG000 | Standard Contact Investigation [Control]: Sequence 1 [2 Health Facilities] | Cluster 1: 8 weeks of standard, then 8 weeks of transition, then 48 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG001 | User-centered Contact Investigation [Intervention]: Sequence 1 [2 Health Facilities] | Cluster 1: 8 weeks of standard, then 8 weeks of transition, then 48 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| FG002 | Standard Contact Investigation [Control]: Sequence 2 [2 Health Facilities] | Cluster 2: 16 weeks of standard, then 8 weeks of transition, then 40 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG003 | User-centered Contact Investigation [Intervention]: Sequence 2 [2 Health Facilities] | Cluster 2: 16 weeks of standard, then 8 weeks of transition, then 40 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| FG004 | Standard Contact Investigation [Control]: Sequence 3 [2 Health Facilities] | Cluster 3: 24 weeks of standard, then 8 weeks of transition, then 32 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG005 | User-centered Contact Investigation [Intervention]: Sequence 3 [2 Health Facilities] | Cluster 3: 24 weeks of standard, then 8 weeks of transition, then 36 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| FG006 | Standard Contact Investigation [Control]: Sequence 4 [2 Health Facilities] | Cluster 4: 32 weeks of standard, then 8 weeks of transition, then 24 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG007 | User-centered Contact Investigation [Intervention]: Sequence 4 [2 Health Facilities] | Cluster 4: 32 weeks of standard, then 8 weeks of transition, then 24 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| FG008 | Standard Contact Investigation [Control]: Sequence 5 [2 Health Facilities] | Cluster 5: 40 weeks of standard, then 8 weeks of transition, then 16 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG009 | User-centered Contact Investigation [Intervention]: Sequence 5 [2 Health Facilities] | Cluster 5: 40 weeks of standard, then 8 weeks of transition, then 16 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| FG010 | Standard Contact Investigation [Control]: Sequence 6 [2 Health Facilities] | Cluster 6: 48 weeks of standard, then 8 weeks of transition, then 8 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| FG011 | User-centered Contact Investigation [Intervention]: Sequence 6 [2 Health Facilities] | Cluster 6: 48 weeks of standard, then 8 weeks of transition, then 8 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
|
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period 1 (Weeks 1-8) |
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| Period 2 (Weeks 9-16) |
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| Period 3 (Weeks 17-24) |
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| Period 4 (Weeks 25-32) |
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| Period 5 (Weeks 33-40) |
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| Period 6 (Week 41-48) |
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| Period 7 (Weeks 49-56) |
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| Period 8 (Weeks 57-64) |
|
Provided are baseline characteristics for all that participated- both index and household contact participants.
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| ID | Title | Description |
|---|---|---|
| BG000 | Standard Contact Investigation: Index Participants | Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy. Standard contact investigation: Once an eligible TB patient agrees to participate, CHWs will visit the patient to assess the eligibility of close contacts to participate. For eligible contacts who agree to participate, the CHW will perform TB symptom screening and arrange subsequent microbiologic, clinical, and/or radiographic evaluation. Those screening TB symptom-positive will be asked to expectorate a sputum sample, unless under age 5. If under age 5 or unable to produce sputum, contacts will be referred to the health centre for evaluation. A CHW will transport sputum samples to the health-centre laboratory for microbiologic evaluation and later report the test results back to the contact. Standard Implementation Strategy: CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Completion of TB Evaluation | The percentage of participants (close contacts) who are experiencing TB symptoms who complete TB evaluation within 60 days of the TB patient's treatment initiation date | Only those who screened positive for symptoms of TB are included in this analysis | Posted | Count of Participants | Participants | 60 days |
|
60 days
All-Cause Mortality was not collected.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Standard Contact Investigation [Control]: Sequence 1 [2 Health Facilities] | Cluster 1: 8 weeks of standard, then 8 weeks of transition, then 48 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. J. Lucian Davis | Yale School of Public Health | 203-785-3665 | lucian.davis@yale.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Sep 12, 2022 | Jun 9, 2023 | Prot_002.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | May 2, 2023 | Jun 9, 2023 | SAP_003.pdf |
| ICF | No | No | Yes | Informed Consent Form | Sep 12, 2022 | Feb 29, 2024 | ICF_004.pdf |
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| ID | Term |
|---|---|
| D014376 | Tuberculosis |
| D014397 | Tuberculosis, Pulmonary |
| ID | Term |
|---|---|
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
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The investigators will conduct a stepped-wedge, cluster-randomized implementation trial with nested mixed-methods evaluations of fidelity and context and health economic analyses. The stepped-wedge trial will include six transition steps in a complete (also known as closed) design, providing a 1:1 ratio of time periods allocated to the pre-implementation standard strategy and the post-implementation user-centered strategy.
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Blinding of the assigned intervention is not feasible with the stepped-wedge cluster randomized implementation trial design, because interventions are implemented at the health-facility level and all health facilities receive the standard strategy followed by the enhanced, user-centered strategy. Community Health Workers will collect all data, and adjudicate all outcomes, except TB diagnoses and treatments initiated which will be collected from on-site National TB and Leprosy Programme registers. Where possible, the investigators and study staff, except for the statistician and data manager, will be blinded to any aggregated analyses of TB outcomes by study period.
|
|
| Standard Implementation Strategy | Behavioral | Once an eligible TB patient agrees to participate, CHWs will visit the patient to assess the eligibility of close contacts to participate. For eligible contacts who agree to participate, the CHW will perform TB symptom screening and arrange subsequent microbiologic, clinical, and/or radiographic evaluation. Those screening TB symptom-positive will be asked to expectorate a sputum sample, unless under age 5. If under age 5 or unable to produce sputum, contacts will be referred to the health centre for evaluation. A CHW will transport sputum samples to the health-centre laboratory for microbiologic evaluation and later report the test results back to the contact. During the standard implementation strategy period, CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
|
|
The difference between study periods in percentage of contacts initiating TB preventative therapy (TPT) within 60 days of the TB patient's treatment initiation |
| 60 days |
| Number of Contacts Diagnosed With Active TB | The difference between study periods in counts of the number of contacts diagnosed with active TB | 60 days |
| Number of Contacts Initiating TB Preventative Therapy | The difference between study periods in counts of the number of contacts initiating TPT | 60 days |
| TB Yield (All Contacts) | The difference between study periods in percentage of all TB cases among contacts | 60 days |
| Katamba A, Gupta AJ, Turimumahoro P, Ochom E, Ggita JM, Nakasendwa S, Nanziri L, Musinguzi J, Hennein R, Sekadde M, Hanrahan C, Byaruhanga R, Yoeli E, Turyahabwe S, Cattamanchi A, Dowdy DW, Haberer JE, Armstrong-Hough M, Kiwanuka N, Davis JL. A user-centred implementation strategy for tuberculosis contact investigation in Uganda: Protocol for a stepped-wedge, cluster-randomised trial. Res Sq [Preprint]. 2023 Jul 6:rs.3.rs-3121275. doi: 10.21203/rs.3.rs-3121275/v1. |
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| Index Participants |
|
| Close Contacts |
|
| COMPLETED |
|
| NOT COMPLETED |
|
| BG001 | Standard Contact Investigation: Household Contacts | Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy. Standard contact investigation: Once an eligible TB patient agrees to participate, CHWs will visit the patient to assess the eligibility of close contacts to participate. For eligible contacts who agree to participate, the CHW will perform TB symptom screening and arrange subsequent microbiologic, clinical, and/or radiographic evaluation. Those screening TB symptom-positive will be asked to expectorate a sputum sample, unless under age 5. If under age 5 or unable to produce sputum, contacts will be referred to the health centre for evaluation. A CHW will transport sputum samples to the health-centre laboratory for microbiologic evaluation and later report the test results back to the contact. Standard Implementation Strategy: CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. |
| BG002 | User-centered Contact Investigation: Index Participants | User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies Client-centered adaptations of contact investigation delivered as a branded package called Tuli Wamu Nawe: Four novel tools TB education pamphlet to help index TB persons disclose the need for TB screening to close contacts. Contact identification algorithm to help CHWs and index TB persons accurately enumerate contacts. Sputum collection video to instruct contacts to expectorate good-quality sputum. Community Health Riders to transport CHWs, index persons with TB, and contacts by motorcycle taxi, and collect and transport sputum. CHW-centered Implementation Strategy: Three components Weekly CHW meetings to create communities of practice (CoP), which consist of professionals organized for peer support and systematic learning. Audit and feedback reports on contact investigation performance indicators delivered weekly (individual CHW) and monthly (health facility). A group-chat application to facilitate peer support among CHWs. |
| BG003 | User-centered Contact Investigation: Household Contacts | User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies Client-centered adaptations of contact investigation delivered as a branded package called Tuli Wamu Nawe: Four novel tools TB education pamphlet to help index TB persons disclose the need for TB screening to close contacts. Contact identification algorithm to help CHWs and index TB persons accurately enumerate contacts. Sputum collection video to instruct contacts to expectorate good-quality sputum. Community Health Riders to transport CHWs, index persons with TB, and contacts by motorcycle taxi, and collect and transport sputum. CHW-centered Implementation Strategy: Three components Weekly CHW meetings to create communities of practice (CoP), which consist of professionals organized for peer support and systematic learning. Audit and feedback reports on contact investigation performance indicators delivered weekly (individual CHW) and monthly (health facility). A group-chat application to facilitate peer support among CHWs. |
| BG004 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Person living with HIV | Number | participants |
|
| OG001 | Enhanced Contact Investigation Intervention Period | The enhanced contact investigation strategy includes 4 implementation facilitation tools and 3 continuous quality improvement techniques delivered as a branded package. Implementation tools include 1) a TB education pamphlet, 2) a contact identification algorithm, 3) an instructional video on sputum collection, and 4) community health riders who transport clients, community health workers, and sputum samples by motorcycle. The continuous quality improvement techniques delivered as the community of practice package include 1) community of practice meetings, 2) audit and feedback reports and 3) a group chat application. User-Centered Implementation Strategy: 1) 4 participant-facing components: 1a) TB education pamphlet helps index TB persons disclose the need for household screening to contacts. 1b) Contact identification algorithm helps CHWs and index TB persons accurately enumerate contacts. 1c) Sputum collection video instructs contacts to expectorate good-quality sputum. 1d) Community Health Riders transport CHWs, index persons with TB, and contacts by motorcycle taxi, and collect and transport sputum. 2) 3 community health-worker-facing components: a) Weekly CHW meetings create communities of practice (CoP), professionals organized for peer support and systematic learning. 2b) Audit and feedback reports on contact investigation performance indicators weekly (individual CHW) and monthly (health facility). 2c) A group-chat application facilitates peer support among CHWs. |
|
|
|
| Secondary | TB Yield (Diagnosis and Treatment Initiation) | The difference between study periods in percentage of contacts diagnosed with active TB and initiated on treatment within 60 days of the TB patient's treatment initiation | Posted | Count of Participants | Participants | 60 days |
|
|
|
|
| Secondary | Initiation of TB Preventative Therapy | The difference between study periods in percentage of contacts initiating TB preventative therapy (TPT) within 60 days of the TB patient's treatment initiation | Only those eligible for TPT are included in this analysis. Those that have been newly diagnosed with TB, regardless of treatment status, are not eligible for TPT and are therefore excluded from this analysis | Posted | Count of Participants | Participants | 60 days |
|
|
|
|
| Secondary | Number of Contacts Diagnosed With Active TB | The difference between study periods in counts of the number of contacts diagnosed with active TB | Posted | Count of Participants | Participants | No | 60 days |
|
|
|
| Secondary | Number of Contacts Initiating TB Preventative Therapy | The difference between study periods in counts of the number of contacts initiating TPT | This outcome is only for those eligible to initiate TPT. Those who have been newly diagnosed, regardless of treatment status, are not eligible for TPT and are therefore excluded from this outcome. | Posted | Count of Participants | Participants | No | 60 days |
|
|
|
| Secondary | TB Yield (All Contacts) | The difference between study periods in percentage of all TB cases among contacts | Posted | Count of Participants | Participants | 60 days |
|
|
|
|
| 0 |
| 0 |
| 0 |
| 85 |
| 0 |
| 85 |
| EG001 | User-centered Contact Investigation [Intervention]: Sequence 1 [2 Health Facilities] | Cluster 1: 8 weeks of standard, then 8 weeks of transition, then 48 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 1,516 | 0 | 1,516 |
| EG002 | Standard Contact Investigation [Control]: Sequence 2 [2 Health Facilities] | Cluster 2: 16 weeks of standard, then 8 weeks of transition, then 40 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. | 0 | 0 | 0 | 650 | 0 | 650 |
| EG003 | User-centered Contact Investigation [Intervention]: Sequence 2 [2 Health Facilities] | Cluster 2: 16 weeks of standard, then 8 weeks of transition, then 40 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 1,983 | 0 | 1,983 |
| EG004 | Standard Contact Investigation [Control]: Sequence 3 [2 Health Facilities] | Cluster 3: 24 weeks of standard, then 8 weeks of transition, then 32 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. | 0 | 0 | 0 | 516 | 0 | 516 |
| EG005 | User-centered Contact Investigation [Intervention]: Sequence 3 [2 Health Facilities] | Cluster 3: 24 weeks of standard, then 8 weeks of transition, then 36 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 1,663 | 0 | 1,663 |
| EG006 | Standard Contact Investigation [Control]: Sequence 4 [2 Health Facilities] | Cluster 4: 32 weeks of standard, then 8 weeks of transition, then 24 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. | 0 | 0 | 0 | 471 | 0 | 471 |
| EG007 | User-centered Contact Investigation [Intervention]: Sequence 4 [2 Health Facilities] | Cluster 4: 32 weeks of standard, then 8 weeks of transition, then 24 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 841 | 0 | 841 |
| EG008 | Standard Contact Investigation [Control]: Sequence 5 [2 Health Facilities] | Cluster 5: 40 weeks of standard, then 8 weeks of transition, then 16 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. | 0 | 0 | 0 | 669 | 0 | 669 |
| EG009 | User-centered Contact Investigation [Intervention]: Sequence 5 [2 Health Facilities] | Cluster 5: 40 weeks of standard, then 8 weeks of transition, then 16 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 443 | 0 | 443 |
| EG010 | Standard Contact Investigation [Control]: Sequence 6 [2 Health Facilities] | Cluster 6: 48 weeks of standard, then 8 weeks of transition, then 8 weeks of user-centered ----------------- Standard contact investigation consists of 1) evidence-based procedures for TB contact investigation, introduced with 2) a standard implementation strategy.
CHWs at all sites will receive the standard TB program training on TB contact investigation and supportive supervision from the on-site National TB Program focal person. | 0 | 0 | 0 | 1,326 | 0 | 1,326 |
| EG011 | User-centered Contact Investigation [Intervention]: Sequence 6 [2 Health Facilities] | Cluster 6: 48 weeks of standard, then 8 weeks of transition, then 8 weeks of user-centered ----------------- User-centered Contact Investigation includes 4 client-facing adaptations of standard contact investigation and 3 CHW-facing implementation strategies
| 0 | 0 | 0 | 314 | 0 | 314 |
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| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D012141 | Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |