Fig. 3

Flow chart illustrating the implementation of the one-time component of the intervention. Adults (15 years and above) are contacted at random as part of the one-time campaign; the intervention coverage (70% in the reference scenario) determines the proportion of adults who receive the initial steps of (i) screening with chest X-ray (CXR) for active tuberculosis (TB) (with Xpert Ultra testing if CXR suggests TB) and (ii) evaluation for latent TB (LTBI) using tuberculin skin test (TST). Those identified with LTBI (based on TST sensitivity) are offered preventive therapy; the proportion who successfully complete it (and move to the model’s recovered state) depends on the assumed levels of uptake, completion, and efficacy. Adults found to have active TB (dependent on the combined sensitivity of CXR and Xpert Ultra) are offered treatment; the proportion who move to the recovered state depends on the assumed uptake and treatment cure probability. For individuals identified with TB, all child contacts are further screened for both TB and LTBI (child contact tracing arm) and treated accordingly, similar to adults but accounting for the different sensitivity of TB testing in children and the small proportion of TB-affected children who are contacts of the adults diagnosed with active TB through the intervention. Baseline values for each parameter along the intervention cascade are included within parentheses, and the numbers next to the arrows indicate the cumulative percentage of prevalent cases among adults or children. Please refer to Additional file 1 Table S-2 in the supplementary materials for details on the derivation of these quantities