{"doi":"10.1093/cid/ciad776","title":"Community-Wide Universal HIV Test and Treat Intervention Reduces Tuberculosis Transmission in Rural Uganda: A Cluster-Randomized Trial","abstract":"BACKGROUND: Human immunodeficiency virus (HIV) treatment reduces tuberculosis (TB) disease and mortality; however, the population-level impact of universal HIV-test-and-treat interventions on TB infection and transmission remain unclear. METHODS: In a sub-study nested in the SEARCH trial, a community cluster-randomized trial (NCT01864603), we assessed whether a universal HIV-test-and-treat intervention reduced population-level incident TB infection in rural Uganda. Intervention communities received annual, population-level HIV testing and patient-centered linkage. Control communities received population-level HIV testing at baseline and endline. We compared estimated incident TB infection by arms, defined by tuberculin skin test conversion in a cohort of persons aged 5 and older, adjusting for participation and predictors of infection, and accounting for clustering. RESULTS: Of the 32 trial communities, 9 were included, comprising 90 801 participants (43 127 intervention and 47 674 control). One-year cumulative incidence of TB infection was 16% in the intervention and 22% in the control; SEARCH reduced the population-level risk of incident TB infection by 27% (adjusted risk ratio = 0.73; 95% confidence interval [CI]: .57-.92, P = .005). In pre-specified analyses, the effect was largest among children aged 5-11 years and males. CONCLUSIONS: A universal HIV-test-and-treat intervention reduced incident TB infection, a marker of population-level TB transmission. Investments in community-level HIV interventions have broader population-level benefits, including TB reductions.","journal":"Clinical Infectious Diseases","year":2024,"id":453970,"datarank":0.38463286997617996,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.07271663872420452,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.07271663872420452,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":5,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9462,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01864603"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":255279,"name":"Mucunguzi Atukunda","orcid":"0000-0003-4762-0728","position":1,"is_corresponding":false},{"id":578554,"name":"Joshua R. Nugent","orcid":"0000-0002-4479-9673","position":2,"is_corresponding":false},{"id":255274,"name":"Edwin D. Charlebois","orcid":"0000-0001-7237-2119","position":3,"is_corresponding":false},{"id":255283,"name":"Gabriel Chamie","orcid":"0000-0002-5860-8081","position":4,"is_corresponding":false},{"id":255280,"name":"Florence Mwangwa","orcid":"0000-0001-9467-0950","position":5,"is_corresponding":false},{"id":411684,"name":"Emmanuel Ssemmondo","orcid":"0000-0002-2796-5027","position":6,"is_corresponding":false},{"id":412775,"name":"Joel Kironde","orcid":null,"position":7,"is_corresponding":false},{"id":255277,"name":"Jane Kabami","orcid":"0000-0002-0265-3174","position":8,"is_corresponding":false},{"id":255282,"name":"Asiphas Owaraganise","orcid":"0000-0002-5594-0310","position":9,"is_corresponding":false},{"id":379512,"name":"Elijah Kakande","orcid":"0000-0001-9532-5710","position":10,"is_corresponding":false},{"id":1277230,"name":"Bob Ssekaynzi","orcid":null,"position":11,"is_corresponding":false},{"id":923878,"name":"Rachel Abbott","orcid":"0009-0008-2021-8476","position":12,"is_corresponding":false},{"id":255275,"name":"James Ayieko","orcid":"0000-0002-0324-4006","position":13,"is_corresponding":false},{"id":255289,"name":"Theodore Ruel","orcid":"0000-0002-1105-9126","position":14,"is_corresponding":false},{"id":746786,"name":"Dalsone Kwariisima","orcid":null,"position":15,"is_corresponding":false},{"id":242453,"name":"Moses R. Kamya","orcid":"0000-0001-9106-4234","position":16,"is_corresponding":false},{"id":255295,"name":"Maya L. Petersen","orcid":"0000-0002-5505-153X","position":17,"is_corresponding":false},{"id":58746,"name":"Diane V. Havlir","orcid":"0000-0003-0761-3136","position":18,"is_corresponding":false},{"id":255278,"name":"Laura B. 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