Background
Tuberculosis
in Zambia is a major public health problem, however the country does not have
reliable baseline data on the TB prevalence for impact measurement; therefore
it was among the priority countries identified by the World Health Organization
to conduct a national TB prevalence survey.
Objective
To
estimate the prevalence of tuberculosis among the adult Zambian population aged
15 years and above, in 2013–2014.
Methods
A
cross-sectional population-based survey was conducted in 66 clusters across all
the 10 provinces of Zambia. Eligible participants aged 15 years and above were
screened for TB symptoms, had a chest x-ray (CXR) performed and were offered an
HIV test. Participants with TB symptoms and/or CXR abnormality underwent an
in-depth interview and submitted one spot- and one morning sputum sample for
smear microscopy and liquid culture. Digital data collection methods were used
throughout the process.
Results
Of
the 98,458 individuals who were enumerated, 54,830 (55.7%) were eligible to
participate, and 46,099 (84.1%) participated. Of those who participated,
45,633/46,099 (99%) were screened by both symptom assessment and chest x-ray,
while 466/46,099 (1.01%) were screened by interview only. 6,708 (14.6%) were
eligible to submit sputum and 6,154/6,708 (91.7%) of them submitted at least
one specimen for examination. MTB cases identified were 265/6,123 (4.3%). The
estimated national adult prevalence of smear, culture and bacteriologically
confirmed TB was 319/100,000 (232-406/100,000); 568/100,000 (440-697/100,000);
and 638/100,000 (502-774/100,000) population, respectively. The risk of having
TB was five times higher in the HIV positive than HIV negative individuals. The
TB prevalence for all forms was estimated to be 455 /100,000 population for all
age groups.
Conclusion
The prevalence of tuberculosis in Zambia was higher than
previously estimated. Innovative approaches are required to accelerate the
control of TB.
Below: Reported signs and symptoms among presumptive TB participants
Full article at: http://goo.gl/zy0Fjg
By: Kapata N1,2, Chanda-Kapata P3,2, Ngosa W3, Metitiri M3, Klinkenberg E4,5, Kalisvaart N4, Sunkutu V6, Shibemba A6, Chabala C6, Chongwe G7, Tembo M8,Mulenga L9, Mbulo G6, Katemangwe P6, Sakala S3, Chizema-Kawesha E3, Masiye F10, Sinyangwe G11, Onozaki I12, Mwaba P13, Chikamata D3, Zumla A14,Grobusch MP2.
- 1National TB and Leprosy Control Program, Lusaka, Zambia.
- 2Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- 3Ministry of Health Headquarters, Lusaka, Zambia.
- 4KNCV Tuberculosis Foundation, The Hague, the Netherlands.
- 5Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
- 6University Teaching Hospital, Lusaka, Zambia.
- 7Department of Public Health, University of Zambia, Lusaka, Zambia.
- 8Tropical Diseases Research Centre, Ndola, Zambia.
- 9Chest Diseases Laboratory, Ministry of Health, Lusaka, Zambia.
- 10Department of Economics, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
- 11United States Agency for International Development, Country Mission, Lusaka, Zambia.
- 12Global Tuberculosis Programme, World Health Organisation, Geneva, Switzerland.
- 13Ministry of Home Affairs headquarters, Lusaka, Zambia.
- 14Division of Infection and Immunity, Department of Infection, University College London, London, United Kingdom.
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