Monday, January 18, 2016

The Prevalence of Tuberculosis in Zambia: Results from the First National TB Prevalence Survey, 2013–2014

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.

To estimate the prevalence of tuberculosis among the adult Zambian population aged 15 years and above, in 2013–2014.

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.

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.

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:

  • 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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