# Mobile Health and Oral Testing to Optimize Tuberculosis Contact Tracing in Colombia

> **NIH NIH R21** · YALE UNIVERSITY · 2023 · $215,304

## Abstract

PROJECT SUMMARY
Nearly one-third of the 10 million annual tuberculosis (TB) cases worldwide are missed each year. TB
contact tracing is an evidence-based practice that is internationally recommended for finding, treating,
and preventing TB among close contacts of TB patients. Contact tracing is also considered a highly
significant strategy for advancing the WHO and PAHO goal of eliminating TB in moderate-incidence
countries like Colombia by 2050. Unfortunately, large implementation gaps persist. Specifically there is
need for 1) better TB screening and testing tools to overcome the low sensitivity of symptom screening
and the difficulty of collecting sputum in those without cough, and 2) more client-centered
implementation strategies to improve case-finding and linkage to care. In prior work with the Secretariat
of Public Health (SPH) in Cali, Colombia, we introduced client-friendly education materials, home
sputum collection and transport, and molecular testing for TB. The COVID-19 pandemic has led to
further evolution of this service to accommodate telehealth visits, and there is need to further adapt
these tools to client expectations and the new digital health landscape. Two of the most promising
innovations for achieving these goals are pairing next-generation molecular testing with non-sputum
samples like saliva and oral swabs to simplify and improve screening and testing algorithms; and
incorporating chat apps (e.g., WhatsApp) and automated customer support tools (i.e., chatbots) as
mobile health (mHealth) tools to engage, support, and retain household members. Our scientific
approach will be to carry out two cross-sectional studies with nested mixed-methods and design
research to refine and adapt these tools for contact tracing. Our overall objectives are to enhance the
sensitivity, feasibility, acceptability, and appropriateness of contact tracing, and to prepare for a future
household-randomized implementation trial. We propose two specific aims: 1) To determine the
diagnostic performance of oral samples for TB molecular testing in possible TB patients in clinic and
household settings; and 2) To design and iteratively refine an mHealth strategy for implementing
contact tracing optimized for feasibility, acceptability, usability, and appropriateness. The investigative
team has expertise in TB diagnostics and clinical care, contact tracing, user-centered design, qualitative
methods, and implementation science, and a well-established partnership with the SPH that will ensure
an outstanding environment for the proposed research. These studies will determine if oral samples
are viable for molecular diagnosis of TB and refine an mHealth strategy for household TB contact
tracing, using an innovative design approach that is both theory-informed and community-engaged.
This study will ultimately deliver client-centered implementation components for an mHealth contact
tracing strategy for future evaluation in a randomized, controlled implementatio...

## Key facts

- **NIH application ID:** 10667885
- **Project number:** 1R21AI174129-01A1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** John Lucian Davis
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $215,304
- **Award type:** 1
- **Project period:** 2023-02-02 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10667885

## Citation

> US National Institutes of Health, RePORTER application 10667885, Mobile Health and Oral Testing to Optimize Tuberculosis Contact Tracing in Colombia (1R21AI174129-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10667885. Licensed CC0.

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