An evaluation of 'Ribolola': a household tuberculosis contact tracing programme in North West Province, South Africa.

SETTING

Rural/peri-urban community, South Africa.

OBJECTIVES

To examine the yield of tuberculosis (TB) cases, TB preventive therapy (TBPT) initiation and human immunodeficiency virus (HIV) diagnoses from household TB contact tracing.

DESIGN

Retrospective programme analysis.

METHODS

Households of index TB cases were visited and their contacts screened for TB and HIV. TB suspects provided sputum or were referred for assessment. Contacts aged <5 years were referred for assessment for TBPT initiation.

RESULTS

There were 732 index TB cases (67.1% HIV-positive). Among 3627 household contacts, 3573 (98.5%) had known outcomes, of which 183 (5.0%) were already on appropriate treatment. Among 3390 remaining contacts, 361 (10.6%) were aged <5 years, of whom 34 (9.4%) started anti-tuberculosis treatment and 286 (79.2%) started TBPT. Among 3029 contacts aged ≥5 years, 93 (3.1%) started anti-tuberculosis treatment: 19 (20.4%) were smear-positive and 71 (76.3%) were culture-positive. Among contacts aged ≥14 years, 794/2133 (37.2%) underwent HIV testing, of whom 208/794 (26.2%) tested positive.

CONCLUSIONS

Household active case finding in this high TB and HIV prevalence setting obtained high yields of TB, particularly in those aged <5 years, and facilitated assessment for TBPT. There was a good yield of new HIV diagnoses, and a gain in efficiency due to integration within one programme.