ArticleIJTLD open2026
Lessons learned from implementing a large-scale contact investigation and TB preventive treatment project in India.
Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTB preventive treatment (TPT) is central to reducing TB incidence among high-risk populations. This paper presents learnings from a large-scale TPT implementation under a Global Fund-supported project in India.
methodsThe project targeted household contacts (HHCs) of people with pulmonary TB (PTB) across 208 districts in 23 states. Data on symptom-based screening, TPT initiation, adherence, and completion were analysed to inform scale-up strategies.
resultsOf 3,097,831 HHCs identified from 851,974 people with PTB, 91% were symptom-screened, and among those screened 28% underwent chest X-ray and 54% initiated TPT, with an 84% completion rate. Integration with active case finding, portable digital chest X-rays, and short-course regimens (3HP) improved coverage. Decentralised service delivery through Health and Wellness Centres and engagement of community health workers enhanced treatment access and follow-up. Teleconsultations, digital tracking, and incentive mechanisms supported adherence. Challenges included early discontinuation due to adverse drug reactions, regional diagnostic disparities, and limited private sector engagement.
conclusionLarge-scale TPT delivery is feasible in high-burden settings when integrated with routine health system platforms and community-based approaches. Key operational insights included chest X-ray screening, and scale-up of shorter regimens, supporting India's TB elimination goals.
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