Managing TB infection among household contacts of patients with pulmonary TB

One third of India's population has TB infection (TBI) with 10% at risk of developing TB disease. A multi-centric TBI initiative for household contacts (HHCs) of people with pulmonary TB (PTB) was implemented.

The project Joint Effort for Elimination of TB was implemented in collaboration with India's National TB Elimination Programme from April 2021 to March 2024. This included doorstep ruling out of TB disease, screening HHCs for TBI, provision of TB preventive treatment (TPT), and adverse events management.

Of the 151,890 notified patients with PTB, 138,812 (91%) could be contacted. Of these, 112,687 (74%) consented to home visits and 94,621 (63%) households were visited. During the visits, 403,923 HHCs were identified, of whom 398,822 (99%) were screened for TBI; 310,605 (77%) consented and 253,885 (63%) initiated on TPT. Adverse events were reported by 3% HHCs with no serious episodes. Of the eligible 148,715 HHCs on TPT, 130,304 (88%) completed with an increasing trend in the TPT completion.

This community-based model for TBI management is feasible and effective. High screening and treatment completion rates alongside minimal adverse events prove this strategy is scalable and replicable for other high-burden settings worldwide.