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Using an implementation science approach to refine, implement and evaluate pilot strategies for tuberculosis contact tracing in South Africa

Award Number: K01HL151977
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 06/15/2021
PERIOD OF PERFORMANCE END DATE: 05/31/2026

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Using an implementation science approach to refine, implement and evaluate pilot strategies for tuberculosis contact tracing in South Africa - PROJECT SUMMARY Tuberculosis (TB) remains a global health emergency, responsible for 10 million new cases and 1.5 million deaths in 2018. The Stop TB Partnership has set very ambitious targets that include a 50% reduction in TB incidence from 2015 to 2025. Strategies to find people with active TB earlier in their disease course must therefore be rapidly scaled up if TB control targets for 2025 are to be approached. However, active case finding or TB is expensive and difficult to implement in practice, particularly tracing close contacts of newly diagnosed TB cases. One innovative approach to contact tracing is to forego household visits in favor of small incentives to the TB case and their contact for the contacts to present to the clinic for TB screening. This proposed research is a novel study looking at barriers to implementation of incentive-based contact tracing, refining the strategy to modify these barriers and pilot testing it in the high burden setting of rural South Africa. We will measure acceptability, feasibility, reach, implementation and generate pilot effectiveness data which can be used to plan for scale-up. The proposed study will be in the rural district of Vhembe, South Africa – a district with a TB incidence of 350 per 100,000/year. We will assess barriers to implementation using quantitative surveys and qualitative interviews with TB cases and their contacts who received the intervention in the context of a cluster-randomized controlled trial, as well as healthcare workers. We will prioritize barriers with stakeholders and devise a refined incentive-based tracing implementation strategy. We will pilot test this strategy in 6 public primary health clinics within Vhembe, and examine implementation and preliminary effectiveness. The specific aims of this research are: (1) To identify individual and systems-level barriers and facilitators to the implementation of incentive-based contact tracing in a high burden setting; (2) To develop and pilot test an improved contact tracing strategy. This multidisciplinary research represents an innovative path toward achieving medium-term TB control targets in a key epidemiological setting, and can also serve as a methodological example of how to improve real-world decision-making across a broad array of other fields in the context of urgent and ambitious population health priorities.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $160,257 )
2024	2024	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Lung Diseases Research	000	4	6/17/2024	NON-COMPETING CONTINUATION	$160,257
														Subtotal = $160,257

Issue Date FY: 2023 ( Subtotal = $161,258 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Lung Diseases Research	000	3	6/8/2023	NON-COMPETING CONTINUATION	$161,258
														Subtotal = $161,258

Issue Date FY: 2022 ( Subtotal = $162,153 )
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Lung Diseases Research	000	2	5/14/2022	NON-COMPETING CONTINUATION	$162,153
														Subtotal = $162,153

Issue Date FY: 2021 ( Subtotal = $162,373 )
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Lung Diseases Research	000	1	6/14/2021	NEW	$162,373
														Subtotal = $162,373

Grand Total All Awards = $646,041

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Using an implementation science approach to refine, implement and evaluate pilot strategies for tuberculosis contact tracing in South Africa

Award Number: K01HL151977

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 06/15/2021

PERIOD OF PERFORMANCE END DATE: 05/31/2026

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