title: Plan Beta for tuberculosis: it's time to think seriously about poorly ventilated congregate settings.
abstract: Globally, the rates of decline in tuberculosis (TB) incidence are disappointing, but in line with model predictions regarding the likely impact of the DOTS strategy. Here, we review evidence from basic epidemiology, molecular epidemiology and modelling, all of which suggest that, in high-burden settings, the majority of Mycobacterium tuberculosis transmission may occur in indoor congregate settings. We argue that mass environmental modifications in these places might have a significant impact on TB control and suggest a research agenda that might inform interventions of this nature. The necessary technology exists and, critically, implementation would not be dependent on health care workers who are in short supply in the communities worst affected by TB.
authors.affiliation: Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; Wellcome Trust Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa.
authors.forename: T A
authors.initials: TA
authors.lastname: Yates
authors.affiliation: Wellcome Trust Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa; School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: F
authors.initials: F
authors.lastname: Tanser
authors.affiliation: Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, London, UK; Medical Research Council Clinical Trials Unit, University College London, London, UK.
authors.forename: I
authors.initials: I
authors.lastname: Abubakar
mesh_terms: D004780:Environment, Controlled; D014943:Global Health; D006801:Humans; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000517:prevention & control*