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

Nathan Kapata, Pascalina Chanda-Kapata, William Ngosa, Mine Metitiri, Eveline Klinkenberg, Nico Kalisvaart, Veronica Sunkutu, Aaron Shibemba, Chishala Chabala, Gershom Chongwe, Mathias Tembo, Lutinala Mulenga, Grace Mbulo, Patrick Katemangwe, Sandra Sakala, Elizabeth Chizema-Kawesha, Felix Masiye, George Sinyangwe, Ikushi Onozaki, Peter Mwaba, Davy Chikamata, Alimuddin Zumla and Martin P Grobusch

PLOS ONE, 2016, vol. 11, issue 1, 1-14

Abstract: 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.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0146392

DOI: 10.1371/journal.pone.0146392

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