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Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns

There is an emerging consensus that achieving global tuberculosis control targets will require more proactive case finding approaches than are currently used in high-incidence settings. Household contact tracing (HHCT), for which households of newly diagnosed cases are actively screened for addition...

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Autores principales: Havumaki, Joshua, Cohen, Ted, Zhai, Chengwei, Miller, Joel C., Guikema, Seth D., Eisenberg, Marisa C., Zelner, Jon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895355/
https://www.ncbi.nlm.nih.gov/pubmed/33556077
http://dx.doi.org/10.1371/journal.pcbi.1008713
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author Havumaki, Joshua
Cohen, Ted
Zhai, Chengwei
Miller, Joel C.
Guikema, Seth D.
Eisenberg, Marisa C.
Zelner, Jon
author_facet Havumaki, Joshua
Cohen, Ted
Zhai, Chengwei
Miller, Joel C.
Guikema, Seth D.
Eisenberg, Marisa C.
Zelner, Jon
author_sort Havumaki, Joshua
collection PubMed
description There is an emerging consensus that achieving global tuberculosis control targets will require more proactive case finding approaches than are currently used in high-incidence settings. Household contact tracing (HHCT), for which households of newly diagnosed cases are actively screened for additional infected individuals is a potentially efficient approach to finding new cases of tuberculosis, however randomized trials assessing the population-level effects of such interventions in settings with sustained community transmission have shown mixed results. One potential explanation for this is that household transmission is responsible for a variable proportion of population-level tuberculosis burden between settings. For example, transmission is more likely to occur in households in settings with a lower tuberculosis burden and where individuals mix preferentially in local areas, compared with settings with higher disease burden and more dispersed mixing. To better understand the relationship between endemic incidence levels, social mixing, and the impact of HHCT, we developed a spatially explicit model of coupled household and community transmission. We found that the impact of HHCT was robust across settings of varied incidence and community contact patterns. In contrast, we found that the effects of community contact tracing interventions were sensitive to community contact patterns. Our results suggest that the protective benefits of HHCT are robust and the benefits of this intervention are likely to be maintained across epidemiological settings.
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spelling pubmed-78953552021-03-01 Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns Havumaki, Joshua Cohen, Ted Zhai, Chengwei Miller, Joel C. Guikema, Seth D. Eisenberg, Marisa C. Zelner, Jon PLoS Comput Biol Research Article There is an emerging consensus that achieving global tuberculosis control targets will require more proactive case finding approaches than are currently used in high-incidence settings. Household contact tracing (HHCT), for which households of newly diagnosed cases are actively screened for additional infected individuals is a potentially efficient approach to finding new cases of tuberculosis, however randomized trials assessing the population-level effects of such interventions in settings with sustained community transmission have shown mixed results. One potential explanation for this is that household transmission is responsible for a variable proportion of population-level tuberculosis burden between settings. For example, transmission is more likely to occur in households in settings with a lower tuberculosis burden and where individuals mix preferentially in local areas, compared with settings with higher disease burden and more dispersed mixing. To better understand the relationship between endemic incidence levels, social mixing, and the impact of HHCT, we developed a spatially explicit model of coupled household and community transmission. We found that the impact of HHCT was robust across settings of varied incidence and community contact patterns. In contrast, we found that the effects of community contact tracing interventions were sensitive to community contact patterns. Our results suggest that the protective benefits of HHCT are robust and the benefits of this intervention are likely to be maintained across epidemiological settings. Public Library of Science 2021-02-08 /pmc/articles/PMC7895355/ /pubmed/33556077 http://dx.doi.org/10.1371/journal.pcbi.1008713 Text en © 2021 Havumaki et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Havumaki, Joshua
Cohen, Ted
Zhai, Chengwei
Miller, Joel C.
Guikema, Seth D.
Eisenberg, Marisa C.
Zelner, Jon
Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title_full Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title_fullStr Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title_full_unstemmed Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title_short Protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
title_sort protective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895355/
https://www.ncbi.nlm.nih.gov/pubmed/33556077
http://dx.doi.org/10.1371/journal.pcbi.1008713
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