# Strategies for tuberculosis control in prisons

> **NIH NIH R01** · STANFORD UNIVERSITY · 2021 · $655,282

## Abstract

Project Summary
Tuberculosis is the leading cause of death by an infectious disease worldwide.
Tuberculosis control strategies in low- and middle-income countries (LMICs), which bear
the major burden of TB, currently suffer from two major gaps in the scientific evidence on
program implementation, which must be overcome to achieve global targets: (1) how to
trace the chain of transmission to the major pockets of the population where TB is
increasingly concentrated (i.e., populations serving as reservoirs for broader population
epidemics); and (2) how to efficiently and cost-effectively screen populations within
these concentrated reservoirs. Our preliminary research and those of several other
groups has revealed that prisons are likely to be an important reservoir for tuberculosis
in many LMICs. Mass screening, as suggested by the World Health Organization, could
be an effective means of case detection, but is not widely implemented in LMICs due to
high costs and infrastructure requirements. We propose to leverage unique research and
tuberculosis surveillance infrastructure in prisons and community settings in Central-
Western Brazil to address these critical questions. We will test the following three
hypotheses: 1) a major burden of tuberculosis in communities is attributable to
transmission in prisons; 2) testing pooled sputum samples using a new, sensitive
molecular diagnostic assay (Xpert Ultra) on a mobile diagnostic unit can accurately and
efficient detect tuberculosis cases; and 3) prison-based mass screening can cost-
effectively reduce the community burden of tuberculosis. This project will utilize a novel
statistical modeling approach to infer the directionality of transmission by integrating
tuberculosis natural history, exposure and phylogenetic data derived from whole genome
sequencing. Additionally, this work will generate an open source tool for comparing the
impact of various diagnostic strategies in prisons and other high-burden populations.
Overall, this project addresses persistent scientific barriers to tuberculosis control: how
to clearly identify the contribution of reservoir populations, and how to screen them
efficiently in cost-conscious settings.

## Key facts

- **NIH application ID:** 10102172
- **Project number:** 5R01AI130058-05
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Jason Randolph Andrews
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $655,282
- **Award type:** 5
- **Project period:** 2017-03-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102172

## Citation

> US National Institutes of Health, RePORTER application 10102172, Strategies for tuberculosis control in prisons (5R01AI130058-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10102172. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*