This preprint modelled household contact management for multidrug- or rifampicin-resistant tuberculosis in 189 countries, with age-dependent risks of disease progression, death and adverse events. Adding preventive treatment up to age 45 to a baseline of treatment under 15 was cost-effective at 30% of GDP per capita in 160 countries, including 17 of the 30 highest-incidence countries, while testing for infection before treatment was dominated by treating without testing. Treating contacts of all ages was modelled to avert 9,960 deaths and 289,000 DALYs at a cost of $359 million, alongside 71,000 serious adverse events.
Why it is interesting: The balance of benefit and harm is modelled by age, and testing for infection first is dominated by treating without testing.