Evidence map›Paper›PMID 40503514›Full record

ArticleEClinicalMedicine2025

Innovative timing strategies for tuberculosis household contact investigation: cost-effectiveness analysis from a randomized trial in rural and urban South Africa (Kharituwe Study).

Neenah Young, Patrick Biché, Mbali Mohlamonyane, Matshidiso Morolo, Babalwa Maholwana, Khatija Ahmed, Neil Martinson, Colleen F Hanrahan, David W Dowdy

Registry-linked trialAbstract read
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In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04520113 (Innovative Contact Tracing Strategies for Detecting TB in Mobile Rural and Urban South African Populations), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04520113 nacompletednot on this map

Innovative Contact Tracing Strategies for Detecting TB in Mobile Rural and Urban South African Populations

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2020 to 2025Enrolled10,579ConditionsTuberculosis, HivArmsHousehold contact tracing
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Neenah YoungDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Patrick BichéDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Mbali MohlamonyanePerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Matshidiso MoroloSetshaba Research Centre, Tshwane, Soshanguve, South Africa.
Babalwa MaholwanaSetshaba Research Centre, Tshwane, Soshanguve, South Africa.
Khatija AhmedSetshaba Research Centre, Tshwane, Soshanguve, South Africa.
Neil MartinsonPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Colleen F HanrahanDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
David W DowdyDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Funding

Innovative Contact Tracing Strategies for Detecting TB in Mobile Rural and Urban South African PopulationsR01AI147681 · NIAID · JOHNS HOPKINS UNIVERSITY · PI DOWDY, DAVID WESLEY · 2019 to 2023
$3.2M
NIAID NIH HHS R01 AI147681
6 · The paper itself

Abstract

Background: Household contact investigation (HCI) for tuberculosis (TB) is recommended but often limited by resource constraints, particularly for individuals unavailable during business hours. Methods: We conducted an economic evaluation from January 1, 2022, through December 31, 2022, nested within a randomized trial in South Africa ("Kharituwe") comparing standard HCI for TB and two novel strategies: HCI during holiday periods in a rural setting and off-peak HCI during weekends and evenings in an urban setting. Costs were derived from 2022 expenditures, and secondary TB cases were defined by positive sputum cultures. As a secondary outcome of the Kharituwe Study, we assessed the incremental cost-effectiveness ratio (ICER) of each strategy against a hypothetical no-HCI scenario from the health system perspective in 2022 US dollars. Cost-effectiveness was assessed using a country-specific willingness-to-pay threshold of US$3015 per disability-adjusted life year (DALY) averted. The trial is registered with clincaltrials.gov (NCT04520113). Findings: Relative to a hypothetical no-HCI approach, standard HCI was estimated to cost US$1400 [95% uncertainty interval (UI): $1000-$2100] per DALY averted in the urban setting and US$3600 [95% UI: $2500-$5400] in the rural setting. Corresponding cost-effectiveness ratios were US$1900 [95% UI: $1300-$2800] for off-peak (urban) and US$6400 [$3900-$10,000] for holiday-based (rural) HCI. Personnel costs, travel costs (in the rural setting), and TB prevalence among contact persons were primary drivers of cost-effectiveness. Interpretation: HCI for TB is likely cost-effective in urban South Africa and may be cost-effective in rural settings, which face barriers including long travel times and lower TB prevalence. Holiday-based HCI was not found to be cost-effective. Integrating HCI for TB into broader home-based interventions may improve cost-effectiveness. Funding: Funding was provided by the United States National Institute of Allergy and Infectious Diseases (Grant # 5R01AI147681).

Indexed as

Economic evaluationHousehold contact investigationSouth AfricaTuberculosis

Identifiers

PMID40503514
PMCPMC12152915

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.