Improving tuberculosis contact investigation in Chhattisgarh, India: early findings from operational research.

SETTINGS: Chhattisgarh state, central India, implemented measures to improve household contact investigation (HCI) monitoring and decentralising HCI to nearest primary care facility. OBJECTIVES: Comparing bacteriologically confirmed adults (≥18 years) with tuberculosis (TB) from October to December in 2023 and 2025, to assess changes in undergoing HCI, TB diagnosis, and TB preventive therapy (TPT) initiation (overall and children [<5 years]) after introducing HCI monitoring indicators and decentralising HCI to primary care. DESIGN: Operational research using cross-sectional descriptive analysis of programme data. RESULTS: Districts (n = 33) reporting monthly HCI indicators increased from 2 (6%) in October 2025 to 20 (60%) in January 2026. Notifications dropped from 4,221 to 3,196 and diagnosis through sputum microscopy from 1,315 to 51; while diagnosis by rapid molecular tests increased from 2,290 to 2,774. Marginal improvements occurred in current treatment facility as primary peripheral health institutes (46%-54%), undergoing HCI (75%-82.5%), average household contact identified per person with TB (2.8-3.1), and household contacts initiated on TPT (64%-70%). These changes were not observed among child (<5 years) contacts. TB diagnosis among contacts did not improve (overall and children [<5 years]). CONCLUSION: Early findings for HCI monitoring are encouraging. However, prioritising child (<5 years) contacts and bacteriological confirmation at primary care level is urgently needed.