A total of 24
communities in Zambia and Cape Town communities in South Africa,
with 25,000 to 50,000 people in each community will take part in the ZAMSTAR
study. This is a community-randomized trial of two interventions
with a factorial design. All communities will experience
strengthened DOTS programs and access to clinic-based TB/HIV activities.
Six communities will receive community-based
improved case finding of TB. Six other communities will receive
household level TB/HIV integrated activities, and six more
communities will receive community-based improved case finding of TB
plus household level TB/HIV integrated activities. The
remaining six communities will serve as the control.
Progress
Report: Thousands of elementary school-age children in Zambia
and South Africa have been evaluated with TB skin tests to determine the
baseline levels of TB infection in those communities. Thousands of
households are currently being visited in communities similar to those in
the study by teams trained to screen for active TB to determine baseline
levels of TB disease for the purpose of comparison when the study
interventions are complete. Intensive ethnographic evaluations of
communities have been completed by a team of social scientists to aide the
researchers in determining social behaviors and TB ‘hot spots’ in study
communities.
