ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Vikela Ekhaya: A Novel, Community-based, Tuberculosis Contact Management Program in a High Burden Setting.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed.
- Effectiveness of a Home-based Approach to Child Contact Investigation and Tuberculosis Preventive Treatment Management by Community Health Workers in Ethiopia: A Pragmatic Cluster-randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Trial
- Pragmatic cluster-randomized trial of home-based preventive treatment for TB in Ethiopia and South Africa (CHIP-TB).Trials · 2023Trial
- TB preventive treatment coverage among children under six years of age in TB-affected households.IJTLD open · 2025Article
- TB elimination in Southern Africa: overview and critical reflection.IJTLD open · 2025Review
- Community-Based Tuberculosis Preventive Treatment Among Child and Adolescent Household Contacts in Ethiopia.Tropical medicine and infectious disease · 2025Article
- Tuberculosis Preventive Treatment in High TB-Burden Settings: A State-of-the-Art Review.Drugs · 2025Review
- Acceptance and Completion Rates of 3-Month Isoniazid-Rifampicin (3HR) Tuberculosis Preventive Treatment (TPT) Among Contacts of Bacteriologically Confirmed TB Patients-Patients' and Healthcare Workers' Perspectives.Tropical medicine and infectious disease · 2024Article
- Assessing tuberculosis clinical presentation, diagnosis and treatment outcomes among children under 5 years old: results from a cohort of children with presumptive TB in Cameroon and Kenya.BMJ public health · 2024Article
- Modeled estimates of HIV-serodifferent couples in tuberculosis-affected households in four sub-Saharan African countries.PLOS global public health · 2024Article
- Optimizing the cascade of prevention to protect people from tuberculosis: A potential game changer for reducing global tuberculosis incidence.PLOS global public health · 2024Review
- Cost-effectiveness analysis of interventions to improve diagnosis and preventive therapy for paediatric tuberculosis in 9 sub-Saharan African countries: A modelling study.PLoS medicine · 2023Article
- Community-based tuberculosis contact management: Caregiver experience and factors promoting adherence to preventive therapy.PLOS global public health · 2023Article
- Tuberculosis Infection in Children and Adolescents.Pathogens (Basel, Switzerland) · 2022Review
- Tuberculosis care models for children and adolescents: a scoping review.Bulletin of the World Health Organization · 2022Article
- Preventive Treatment for Household Contacts of Drug-Susceptible Tuberculosis Patients.Pathogens (Basel, Switzerland) · 2022Review
- The Value of Chest Radiography in Tuberculosis Preventive Treatment Screening in Children and Adolescents.American journal of respiratory and critical care medicine · 2022Article
- Clinical standards for the diagnosis, treatment and prevention of TB infection.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini.International journal of public health · 2022Article
- Child Contact Case Management-A Major Policy-Practice Gap in High-Burden Countries.Pathogens (Basel, Switzerland) · 2021Review
- Non-adherence and its predictors among pediatric household contacts on tuberculosis preventive therapy in the 3HP era: A multicenter observational study.Therapeutic advances in infectious diseaseArticle
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Authors and funding
13 authors.
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Abstract
backgroundThe prevention of tuberculosis (TB) in child contacts of TB cases and people living with human immunodeficiency virus (HIV) is a public health priority, but global access to TB preventive therapy (TPT) remains low. In 2019, we implemented Vikela Ekhaya, a novel community-based TB contact management program in Eswatini designed to reduce barriers to accessing TPT.
methodsVikela Ekhaya offered differentiated TB and HIV testing for household contacts of TB cases by using mobile contact management teams to screen contacts, assess their TPT eligibility, and initiate and monitor TPT adherence in participants' homes.
resultsIn total, 945 contacts from 244 households were screened for TB symptoms; 72 (8%) contacts reported TB symptoms, and 5 contacts (0.5%) were diagnosed with prevalent TB. A total of 322 of 330 (98%) eligible asymptomatic household contacts initiated TPT. Of 322 contacts initiating TPT, 248 children initiated 3 months of isoniazid and rifampicin and 74 children and adults living with HIV initiated 6 months of isoniazid; 298 (93%) completed TPT. In clustered logistic regression analyses, unknown HIV status (adjusted odds ratio [aOR] 5.7, P = .023), positive HIV status (aOR 21.1, P = .001), urban setting (aOR 5.6, P = .006), and low income (aOR 5.9, P = .001) predicted loss from the cascade of care among TPT-eligible contacts.
conclusionVikela Ekhaya demonstrated that community-based TB household contact management is a feasible, acceptable, and successful strategy for TB screening and TPT delivery. The results of this study support the development of novel, differentiated, community-based interventions for TB prevention and control.
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