The Zambia and South Africa tuberculosis and AIDS reduction study (ZAMSTAR) was a cluster-randomised trial of two interventions to reduce the burden of TB at community-level. One was improved community-wide TB testing and the other a household-level intervention to provide TB and HIV counselling to facilitate prompt diagnosis and treatment. The trial was conducted in 24 communities in Zambia and the Western Cape province of South Africa, in partnership with the Zambia AIDS Related TB (ZAMBART) Project and the Desmond Tutu TB Centre
Around a million people were involved in the trial at a cost of less than one US dollar per person per year. The study’s main finding, published in the Lancet, showed that the household intervention may have reduced prevalence of TB in adults, and that children in the communities that received household counselling were half as likely to become infected with TB.
Data from the trial have already been instrumental in shaping World Health Organization guidelines, both for screening for active TB among people living with HIV and for community TB
Ayles H, Muyoyeta M, Du Toit E, Schaap A, Floyd S, Simwinga M, Shanaube K, Chishinga N, Bond V, Dunbar R, De Haas P, James A, Gey van Pittius NC, Claassens M, Fielding K, Fenty J, Sismanidis C, Hayes RJ, Beyers N, Godfrey-Faussett P. Effect of household and community interventions on the burden of tuberculosis in southern Africa: the ZAMSTAR community randomised trial. Lancet. 2013 Oct 5;382(9899):1183-94.
Murray EJ, Bond VA, Marais BJ, Godfrey-Faussett P, Ayles HM, Beyers N. High levels of vulnerability and anticipated stigma reduce the impetus for tuberculosis diagnosis in Cape Town, South Africa. Health Policy Plan. 2013 Jul;28(4):410-8.