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Open Access Two methods for setting child-focused tuberculosis care targets

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Objective: To allocate resources for household contact investigations, tuberculosis (TB) programs need estimates of the numbers of child contacts requiring care.

Design: We developed two methods to estimate annual numbers of child contacts aged 0–14 years requiring evaluation and treatment. Method 1 combines local data using simple formulas. Using publicly available data, Method 2 uses a linear regression model based on Demographic and Health Survey and World Bank data to estimate the number of children per household, then combines these results with case notifications and risk estimates of disease and infection.

Results: Applying Method 1 to data from Malawi indicated that every year ~21 000 child contacts require evaluation and ~1900 should be diagnosed with TB. Applying Method 2 to all countries suggested that, globally, 2.41 million (95% uncertainty interval [UI] 2.36–2.46) children aged <5 years, and 5.07 million (95%UI 4.81–5.34) children aged 5–14 years live in households of adult patients with known TB. Of these, 239 014 (95%UI 118 649–478581) and 419 816 (95%UI 140600–1 268805), respectively, will have TB. An additional 848 453 (95%UI 705838–1 017551) and 2660 885 (95%UI 2080517–3 413 189), respectively, will be infected.

Conclusion: It is feasible to use available data to set programmatic evaluation and treatment targets to improve care for child contacts of patients with TB.
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Keywords: chemoprophylaxis; contact tracing; epidemiology; households

Document Type: Research Article

Affiliations: 1: Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA 2: Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA 3: Clinton Health Access Initiative, Kigali, Rwanda 4: National Tuberculosis Control Programme, Lilongwe, Malawi 5: Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA, Partners in Health, Boston, Massachusetts, USA

Publication date: June 21, 2016

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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