Household HIV Testing During Tuberculosis Contact Investigation in Tanzania

The overall objective of this study is to determine if active tuberculosis (TB) case finding among persons residing in the same household as a person with active pulmonary TB (household contact investigation) is an effective TB control intervention in a low-income setting with a high incidence of TB and a high prevalence of HIV infection. Specifically, in this project I will determine the feasibility, and measure the impact and cost-effectiveness of training former patients to conduct household TB contact investigation and household HIV testing in Dar es Salaam, Tanzania, a setting with a high incidence of TB and HIV. The study will focus on the households of patients with infectious pulmonary TB; the pilot assessing the feasibility of household HIV testing will focus on newly diagnosed TB and HIV cases. I will seek to determine whether household contact investigation results in earlier diagnosis and an increased yield of previously unidentified active TB cases and whether both interventions are feasible and cost-effective. The translation of these findings into practice will fill a gap in the evidence base that is necessary for policy formulation.