Fig. 1

Participant Flow. Of 7361 individuals (intervention: 3478; usual care: 3883) screened over 20 months, 4815 (intervention: 2441; usual care: 2374) were eligible and enrolled. The main reason for ineligibility was unwillingness to visit one of the follow-up clinics (2119, 88%). Other reasons for ineligibility included: age < 18 years (241, 10%); no regular access to a cell phone (96, 4%); pregnant (85, 4%); currently on TB treatment (34, 1%). Being unable to receive texts, unwilling to participate in the study, not comfortable getting tested, or not comfortable sharing results comprised < 1% of ineligibility. In the intervention arm, 250 (10%) participants were HIV-positive, 219 (9%) were TB-symptomatic, and 37 (2%) were both HIV-positive and TB symptomatic. Of those eligible to give a sputum sample, 240 (56%) successfully produced sputum and 6 (3%) tested GeneXpert-positive. In the usual care arm, 176 (7%) participants were HIV-positive, 205 (9%) were TB-symptomatic, and 29 (1%) were both HIV-positive and TB symptomatic. Of those eligible to give a sputum sample, 91 (26%) successfully produced sputum and 1 (1%) tested GeneXpert-positive