Africa has been in the grip of a severe epidemic of tuberculosis since the onset of the HIV epidemic: the region includes all but one of 15 countries with the highest tuberculosis incidences and accounts for 79% of the global burden of 1·4 million cases of HIV-related tuberculosis. Unlike industrialized countries, most tuberculosis disease in endemic areas is due to recently transmitted rather than remotely acquired infection and most new infections are acquired from casual rather than close household contacts. As such, interventions targeting tuberculosis transmission in the community have high potential ...