Open AccessProtective impacts of household-based tuberculosis contact tracing are robust across endemic incidence levels and community contact patterns
Author(s) -
Joshua Havumaki,
Ted Cohen,
Chengwei Zhai,
Joel C. Miller,
Seth D. Guikema,
Marisa C. Eisenberg,
Jon Zelner
Publication year - 2021
Publication title -
plos computational biology/plos computational biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.628
H-Index - 182
eISSN - 1553-7358
pISSN - 1553-734X
DOI - 10.1371/journal.pcbi.1008713
Subject(s) - contact tracing , tuberculosis , psychological intervention , environmental health , transmission (telecommunications) , incidence (geometry) , medicine , population , disease burden , epidemiology , burden of disease , demography , disease , infectious disease (medical specialty) , pathology , computer science , telecommunications , physics , covid-19 , psychiatry , sociology , optics
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.