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Enhanced Place Finding (EPF) of TB transmission hotspots

Periodic Reporting for period 1 - TB-EPF (Enhanced Place Finding (EPF) of TB transmission hotspots)

Reporting period: 2017-09-01 to 2019-02-28

The Enhanced Place Finding project built on a prior ERC funded project titled “INTERRUPTB”, which focused on Enhanced Case Finding. In the INTERRUPTB project, we studied the ability of a case finding intervention to interrupt transmission. The intervention was unable to achieve a significant decline in TB case notifications and we did not identify a molecular signal of interruption of transmission, which fuelled an innovative approach: identify hotspots of TB transmission through anonymized location data derived from telephone call detail records. Essentially, we aimed to identify public areas where TB transmission takes place, based on the crossing in time and space of former TB patients. At the beginning of the project we convened experts in multiple disciplines in a one-day workshop to discuss the ethical implications of mapping patient’s whereabouts. The findings from this workshop were published in Emerging Infectious Diseases.

The project started off with an initial Data Protection Impact Assessment (DPIA Phase 1) by an independent data security expert, in parallel with recruitment of the study team. The recommendations in the DPIA were reflected in the amended information sheets and consent forms, which were used to recontact former TB patients as well as community controls.

The field team approached approximately 2/3 of all former TB patients who had a bacterial genome available (984 out of 1,500) for analysis from the INTERRUPTB study 2012-2014 (the rest of the participants was not approached due to time constraints), among whom 69.5% were identified and interviewed. Refusal to participate in this study was low (7.2% of individuals traced, 11,6% of those who had not died or travelled). 

The Dalberg team prepared the required algorithms in accordance with the DPIA. The field work was completed a few months after the project ended.