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RFP – Literature Review, Tuberculosis (TB) Contact Investigation, Toronto Public Health

Release Date:  February 6, 2006
Deadline:  February 16, 2006

Proposals are being requested to conduct a review of literature on TB
contact investigation.  This literature review will identify
program-relevant guidelines for establishing an up-to-date framework
for assembling information and using the findings to inform decisions
by Toronto Public Health for initiating contact investigations.

Investigation of contacts and treatment of infected contacts is an
important component of Toronto Public Health's strategy for TB

Although no safe exposure time to airborne Mycobacterium tuberculosis
has been established, TB prevention and control efforts must focus
resources on finding exposed persons who are more likely to be infected
or to become ill with TB disease. Identifying contacts at higher risk
is important as these individuals are at increased risk of developing active disease and require different follow-up.

Previous studies have confirmed the contribution of certain factors:
the extent of disease in the index case, the duration that the source
and the contact are together and their proximity, and local air
circulation. The likelihood of TB disease after an exposure is also
known to be influenced by medical conditions such as HIV and Diabetes
that impair immune competence.  Other risk factors may include the
infective burden of Mycobacterium tuberculosis, previous exposure and
infection, virulence of the Mycobacterium tuberculosis strain, and a
contact's intrinsic predisposition for infection or disease. 
Despite what is known, the predictive value, relative contribution, and
interactions of each of these factors have not been fully studied or

The primary question to be addressed in the required literature review
is who should be considered a contact requiring TB investigation. 
We are particularly interested in specific, quantifiable measures which
can be applied in contact investigations. Specific topics for analysis
and discussion will include, but are not necessarily limited to

  • Characteristics of the index case (e.g., smear positive, cavitary, and cough versus Smear negative, asymptomatic);
  • Average duration of exposure to index case (e.g., eight hours of exposure per week);
  • Physical distance from source case (e.g., within eight feet);
  • Environmental criteria predictive of skin TST conversion or development of active disease;  and,
  • Differences in risk by setting (e.g., hospital emergency rooms,
    high-risk outpatient clinics such as dialysis, HIV, diabetes and
    cancer, shelters, schools, daycares office buildings, correctional

Toronto Public Health requires the following deliverables (in a current
MS Word format, where appropriate) to inform decisions about the need
to update our current contact investigation guidelines:
1.    Meet with TB Program management team as needed.
2.    Develop research questions in collaboration with the TB management team.
3.    Submit literature search methodology and search criteria to the TB management team for approval.
4.    Submit a draft literature review for approval in
electronic format. The report will include a summary and critical
analysis of the literature and program-relevant recommendations.
5.    Submit a final literature review in both
electronic and paper format which includes a summary and critical
analysis of the literature and program-relevant recommendations.

Key Qualifications

  • Significant experience/expertise in applied research and
    evaluation, preferably in a public health setting, especially in
    conducting literature reviews.
  • Preference will be given to those with knowledge of Communicable Disease Control, and TB in particular.
  • Strong project management skills.
  • Demonstrated ability to meet timelines.
  • Excellent written and verbal communication skills, using clear written and verbal language.

Submission Requirements
The following information must be included in your proposal:

  • A resume that clearly demonstrates how your experiences reflect the key qualifications
  • A detailed plan and description of how and when the requested tasks will be executed
  • A breakdown of costs
  • A list of relevant experiences in conducting similar projects
  • Names of 2 references for who you have conducted similar projects

Samples of written reports, research and evaluation documents.

Proposed Timelines
Release of RFP:  February 6, 2006
Deadline for submission of proposals:  February 16, 2006
Proposal Review and candidate short-listing for interview if necessary:  February 17, 2006
Interviews, if necessary:  February 20, 2006
Successful candidate notified:  February 21, 2006
Project start date:  February 27, 2006
Project to be completed by:  April 28, 2006

The budget for this project will not exceed $7,500, including all taxes and disbursements.

Please contact Jennifer Fuller at (416) 338-2377 or by e-mail at jfuller to submit proposals.