Limitations
TB
SECONDARY
Prior to study initiation, routine medical records in both South Africa and Ethiopia lacked sufficient detail to be able to collect the necessary data for all primary and secondary outcomes. Study-wide implementation of a child contact management form was needed across intervention and control clinics. Data points were pragmatic and consistent with best practices from the WHO TPT handbook [Training of healthcare workers, reinforcement of data collection processes, and the presence of research staff may increase the quality of child contact management in standard of care facilities, which may therefore limit the effect size of the intervention.In South Africa, research nurses will be hired to conduct the household visits due to overall staff and OTL shortages. This may impact the generalizability of the study results in South Africa. However, this will not be the case in Ethiopia where the health extension workers, employed by the health system, will be implementing the study.We expect that between-cluster contamination will be limited by country guidelines that require TB patients to seek care at the clinic to which their home is assigned to ensure the clinic’s ability to provide directly-observed therapy for the TB index patient. This, however, is variably enforced by clinics in South Africa where anyone who lives within the catchment area of the study will be treated based on where the index patient sought care. This information will be collected and, if relevant, may be used in sensitivity analyses.