DRIVE-TB

Objective

Evaluate the efficacy of a community-based tuberculosis intervention among people who inject drugs in Hai Phong.

Secondary objectives

• Identify the most efficient community-level tuberculosis screening algorithm.
• Assess the feasibility of mass screening through a community-based respondent-driven sampling survey approach.
• Evaluate peer-facilitated referral to care and treatment retention.
• Estimate active and latent tuberculosis prevalence and incidence among contacts, HIV viraemia prevalence and tuberculosis infection incidence among people who inject drugs.
• Assess the cost-effectiveness of the intervention.

Study design

The study uses a before–after design to evaluate a community-based tuberculosis intervention among people who inject drugs. Four successive respondent-driven sampling survey rounds structure the evaluation. RDSS1 tested a broad screening approach combining a symptom questionnaire, CRP, chest X-ray with CAD4TB, sputum Xpert MTB/RIF and latent tuberculosis infection testing with TST or IGRA. The results informed the screening algorithm used in RDSS2 and RDSS3. RDSS4 provided the final assessment using the symptom questionnaire, chest X-ray and sputum Xpert MTB/RIF.

Intervention components

The community-based intervention evaluated across the four survey rounds comprised:

• Four community-based RDSS rounds for tuberculosis screening.
• A tuberculosis information and communication module adapted for people who inject drugs.
• Peer-group support to facilitate treatment initiation and retention.
• Peer-supported contact tracing and active tuberculosis screening among contacts.