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BACKGROUNDTB control requires the understanding and disruption of TB transmission. We describe prevalence, incidence and risk factors associated with childhood TB infection in Cape Town, South Africa.METHODSWe report cross-sectional baseline and prospective incidence data from a large trial among primary school children living in high TB burden communities. Prevalent infection was defined as QuantiFERON™-TB Gold Plus (QFT-Plus) positivity as assessed at baseline. Subsequent conversion to QFT-Plus positivity was measured 3 years later among those QFT-Plus-negative at baseline. Multivariable logistic regression models examined factors associated with TB infection.RESULTSQuantiFERON-positivity at baseline (prevalence: 22.6%, 95% CI 20.9–24.4), was independently associated with increasing age (aOR 1.24 per additional year, 95% CI 1.15–1.34) and household exposure to TB during the …