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

Author

Listed:
  • 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
  • Martin P Grobusch

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.

Suggested Citation

  • Nathan Kapata & Pascalina Chanda-Kapata & William Ngosa & Mine Metitiri & Eveline Klinkenberg & Nico Kalisvaart & Veronica Sunkutu & Aaron Shibemba & Chishala Chabala & Gershom Chongwe & Mathias Tembo, 2016. "The Prevalence of Tuberculosis in Zambia: Results from the First National TB Prevalence Survey, 2013–2014," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0146392
    DOI: 10.1371/journal.pone.0146392
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