Malawi Liverpool Wellcome Programme

Sustainable Community Wide Approach in Lung Health (SCALE)

SCALE study was a cluster-randomised trial (CRT) investigating one approach to reduce undiagnosed TB by using six-monthly inquiries for chronic cough, and TB and HIV diagnosis provided at the household level. This intervention was supported by four previous studies showing evidence of effectiveness, but with no CRT of sufficient size to estimate its impact on undiagnosed TB. SCALE recruited community members to assist with the identification of chronic cough and helped provide supervised HIV self-testing with the support of volunteer groups in intervention arm clusters. This is a well-established way of more effectively delivering community-based interventions in Africa and Asia. The study closed at the end of May 2023 


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