Study setting
TB, pneumonia, diarrhea, malaria, dehydration
MALARIA, PNEUMONIA, DEHYDRATION, NEONATAL SEPSIS
This study will be conducted over 12 months in two sub-Saharan African settings with high-TB burdens: Ethiopia and South Africa. Both countries have decentralized TB services available at the local clinic. Neither country’s community-health teams currently conduct child contact management at the community-level. The schedule of the study is presented in Fig. SPIRIT study scheduleIn Ethiopia, each health facility is associated with 3–5 health posts in the community that serve 3–5000 persons in the community and are staffed by health extension workers. Health extension workers are community health workers who receive at least 18 months of comprehensive training and weekly supportive supervision from facility-based healthcare workers. The health extension workers diagnose and treat children with malaria, pneumonia, neonatal sepsis, and diarrhea with dehydration, provide childhood immunizations, perform mass TB screening, and provide directly observed treatment for TB index patients. In Ethiopia, HIV only partially drives the TB epidemic where only 5% of TB patients are living with HIV [In South Africa, the Ward-Based Outreach Team (WBOT) system is used to provide home-based services [