Hanrahan CF, et al. - In this trial involving 3,755 people starting tuberculosis (TB) treatment in 56 South African clinics, researchers compared a pragmatically implemented TB contact-tracing strategy with facility-based TB screening in terms of the number of individuals initiating treatment for TB at the clinic (cluster) level in a largely rural high-burden setting. Contact tracing based on symptom screening and Xpert MTB/RIF testing did not increase the rate of treatment initiation for TB vs less the resource-intensive approach of facility-based screening, according to findings. Although contact tracing may identify a high-risk population that should be prioritized by national TB programs for additional case detection, more sensitive diagnostic algorithms are needed to increase population-level TB treatment initiation.