Contact investigation Bangladesh, Kenya, Myanmar, Macedonia, Japan, Mexico, Latvia, Brazil, Philippines, Domenican Republic, United States, Netherlands Facilitators: Dr. Peter Gondrie and Dr. S. Ottmani Rapparteur. Dr. Mary Reichler

What is the current situation? Variation in policies and practices between countries Most countries have policies In intermediate and high incidence settings, implementation is lacking Yield 3-5% new active TB cases among all contacts Considerably higher yield among child contacts

Global policy document in progress Universal contact investigation - at least housholds of smear+ index - source case investigation for child TB priority for investigation to: symptomatic patients children < 5 yrs immunocompromised index case MDR/XDR

Main Conclusions of the Group Contact investigation is likely to contribute to early and increased case detection Operational research is needed to facilitate implementation - what is epidemiologic impact - what is the cost-effectiveness - feasibility - barriers - resource needs 3) Experience in pilot projects in selected countries in an operational research setting is needed 4) In the meantime, all countries should start collecting data in a standardized fashion to permit monitoring and evaluation