title: Effectiveness of contact investigations for tuberculosis control in Arkansas.
abstract: Comprehensive assessment of the effectiveness of contact investigations for tuberculosis (TB) control is still lacking. In this study, we use a computational model, calibrated against notification data from Arkansas during the period 2001-2011, that reproduces independent data on key features of TB transmission and epidemiology. The model estimates that the Arkansas contact investigations program has avoided 18.6% (12.1-25.9%) of TB cases and 23.7% (16.4-30.6%) of TB deaths that would have occurred during 2001-2014 if passive diagnosis alone were implemented. If contacts of sputum smear-negative cases had not been included in the program, the percentage reduction would have been remarkably lower. In addition, we predict that achieving national targets for performance indicators of contact investigation programs has strong potential to further reduce TB transmission and burden. However, contact investigations are expected to have limited effectiveness on avoiding reactivation cases of latent infections over the next 60 years.
authors.affiliation: Fondazione Bruno Kessler, via Sommarive 18, 38123 Povo (TN), Italy; Trento RISE, via Sommarive 18, 38123 Povo (TN), Italy. Electronic address: guzzetta@fbk.eu.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guzzetta
authors.affiliation: Fondazione Bruno Kessler, via Sommarive 18, 38123 Povo (TN), Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ajelli
authors.affiliation: School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI40109-2029, USA.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Arkansas Department of Health, Slot 8, 4815 West Markham Street, Little Rock, AR 72205, USA; University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA.
authors.forename: Leonard N
authors.initials: LN
authors.lastname: Mukasa
authors.affiliation: Arkansas Department of Health, Slot 8, 4815 West Markham Street, Little Rock, AR 72205, USA; University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA.
authors.forename: Naveen
authors.initials: N
authors.lastname: Patil
authors.affiliation: Arkansas Department of Health, Slot 8, 4815 West Markham Street, Little Rock, AR 72205, USA; University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Bates
authors.affiliation: University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Kirschner
authors.affiliation: Fondazione Bruno Kessler, via Sommarive 18, 38123 Povo (TN), Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Merler
mesh_terms: D001131:Arkansas / Q000453:epidemiology; D016358:Contact Tracing; D006801:Humans; D008962:Models, Theoretical; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*
keywords: Contact tracing; Mathematical model; Process assessment (Health Care)