# Feasibility and acceptability of a peer-led strategy to improve community tuberculosis case finding among non-household contacts in Zambia

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $199,800

## Abstract

PROJECT SUMMARY/ABSTRACT
Three million global tuberculosis (TB) cases remain undiagnosed each year, which is a key factor underpinning
why TB is the leading cause of death among people living with HIV (PWH) and the leading infectious cause of
death worldwide. While community-wide screening for TB in high-burden settings is recommended by WHO and
may reduce community prevalence, it is unlikely to be a scalable TB control strategy. Leveraging trained peers
(recent TB patients) to undertake community-based, systematic TB screening among non-household contacts
of newly diagnosed TB patients, including casual contacts at community venues, may be an efficient and
sustainable strategy to facilitate early TB diagnosis and linkage to care; however, little is known about whether
such a strategy is feasible and acceptable to undertake in low-resource, high TB burden settings.
Through targeted training and strong mentorship in implementation science methods, I will develop and evaluate
a theory-informed, multicomponent, peer-led strategy to undertake community-based, systematic TB screening
among non-household contacts of newly diagnosed TB patients attending two public health facilities in Lusaka,
Zambia. This proposal builds upon the research collaboration I began developing during my infectious disease
fellowship and leverages the robust experience and infrastructure of the Centre for Infectious Diseases Research
in Zambia (CIDRZ). In Aim 1, I will undertake mixed-methods research among key stakeholders to identify
barriers to undertaking TB screening among non-household contacts using peers. In Aim 2, I will use a discrete
choice experiment among TB patients, at-risk community members, and community venue owners, to determine
their preferences for the mode of delivery for the implementation strategy components. Findings from Aims 1
and 2 will inform the design of a multicomponent, peer-led TB contact tracing strategy among non-household
contacts that will be evaluated in Aim 3, during a 6-month pilot to assess its feasibility, acceptability and reach.
My overall training objective is to develop implementation science expertise; I will accomplish this by undertaking
carefully selected coursework, workshops, and seminars, and through the guidance of highly accomplished
mentors who are experts in international Implementation science research, mixed-methods research and
multicomponent TB/HIV implementation strategies. My training objectives sequentially map onto my research
aims and are to: (1) gain experience in the application of mixed-methods for implementation science research;
(2) develop expertise in using implementation science methods to develop multicomponent implementation
strategies; (3) develop a strong foundation in study designs and analysis approaches for interventional
implementation research. My career goal is to be an independent physician-scientist who applies implementation
science methods to improve TB and HIV outcomes in low-resource se...

## Key facts

- **NIH application ID:** 10645171
- **Project number:** 5K23AI157914-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Andrew Kerkhoff
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $199,800
- **Award type:** 5
- **Project period:** 2021-07-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10645171

## Citation

> US National Institutes of Health, RePORTER application 10645171, Feasibility and acceptability of a peer-led strategy to improve community tuberculosis case finding among non-household contacts in Zambia (5K23AI157914-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10645171. Licensed CC0.

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