Additional tuberculosis case detection through repeat household contact investigation at 6 and 12 months: a retrospective cohort study in Kasama, a peri-urban district in Zambia

Repeat tuberculosis contact investigation in Kasama District, Zambia, diagnosed 56 additional household TB cases (28.1% of all diagnoses) at 6 and 12 months beyond baseline screening.

• Why it matters: Baseline household contact investigation may miss later-developing TB, but the added value of repeating follow-up in high-burden settings is not well quantified.
• What they did: Using routinely collected programme data, household contacts of bacteriologically confirmed index TB patients (n=1,250) were symptom-screened at baseline, 6, and 12 months across five high-volume facilities.
• The result: TB diagnoses were 143 (3.9%) at baseline, 31 (0.9%) at month 6, and 25 (0.7%) at month 12, totaling 199 (5.5%) across rounds, with 159 (79.9%) bacteriologically confirmed.

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