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

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

doi:10.1371/journal.pone.0146392

Cited by 83 publications

(93 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Participants screening positive for symptoms or having an abnormal chest x-ray submitted a spot and morning sputum for mycobacterial (MTB) investigation at any of the three central reference laboratories. The details of the enrolment, screening and laboratory investigations are outlined elsewhere [7]. …”

Section: Methodsmentioning

confidence: 99%

“…The detailed methods for bacteriological confirmation of TB cases are outlined elsewhere [7]. Rapid HIV testing (with tiebreakers) was performed on site on an opt-out basis accompanied with pre and post-test counselling among consenting individuals using the national algorithm.…”

Section: Methodsmentioning

confidence: 99%

“…The prevalence of all forms of tuberculosis for all ages in 2013–2014 in Zambia was estimated to be 455/100,000 and bacteriologically confirmed TB among adults was 638/100,000 [7], underscoring the fact that Zambia has a high burden of both TB and HIV.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The prevalence of HIV among adults with pulmonary TB at a population level in Zambia

et al. 2017

Self Cite

View full text Add to dashboard Cite

BackgroundTuberculosis and HIV co-infection is one of the main drivers of poor outcome for both diseases in Zambia. HIV infection has been found to predict TB infection/disease and TB has been reported as a major cause of death among individuals with HIV. Improving case detection of TB/HIV co-infection has the potential to lead to early treatment of both conditions and can impact positively on treatment outcomes. This study was conducted in order to determine the HIV prevalence among adults with tuberculosis in a national prevalence survey setting in Zambia, 2013–2014.MethodsA countrywide cross sectional survey was conducted in 2013/2014 using stratified cluster sampling, proportional to population size for rural and urban populations. Each of the 66 countrywide clusters represented one census supervisory area with cluster size averaging 825 individuals. Socio-demographic characteristics were collected during a household visit by trained survey staff. A standard symptom-screening questionnaire was administered to 46,099 eligible individuals across all clusters, followed by chest x-ray reading for all eligible. Those symptomatic or with x-ray abnormalities were confirmed or ruled out as TB case by either liquid culture or Xpert MTBRif performed at the three central reference laboratories. HIV testing was offered to all participants at the survey site following the national testing algorithm with rapid tests. The prevalence was expressed as the proportion of HIV among TB cases with 95% confidence limits.ResultsA total of 265/6123 (4.3%) participants were confirmed of having tuberculosis. Thirty-six of 151 TB survey cases who accepted HIV testing were HIV-seropositive (23.8%; 95% CI 17.2–31.4). The mean age of the TB/HIV cases was 37.6 years (range 24–70). The majority of the TB/HIV cases had some chest x-ray abnormality (88.9%); were smear positive (50.0%), and/or had a positive culture result (94.4%). None of the 36 detected TB/HIV cases were already on TB treatment, and 5/36 (13.9%) had a previous history of TB treatment. The proportion of TB/HIV was higher in urban than in the rural clusters. The HIV status was unknown for 114/265 (43.0%) of the TB cases.ConclusionsThe TB/HIV prevalence in the general population was found to be lower than what is routinely reported as incident TB/HIV cases at facility level. However; the TB/HIV co-infection was higher in areas with higher TB prevalence. Innovative and effective strategies for ensuring TB/HIV co-infected individuals are detected and treated early are required.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The prevalence of HIV among adults with pulmonary TB at a population level in Zambia

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Un participante es elegible para baciloscopia si la radiografía de tórax muestra alguna anormalidad, o si el cuestionario de síntomas identifica síntomas sugestivos de TB (9) . El tamizaje basado en síntomas ha sido adoptado en la mayoría de las recientes encuestas nacionales de TB (10)(11)(12)(13)(14)(15) ; sin embargo, la definición de síntomas varía según la encuesta. Algunos países con limitado recursos para realizar encuestas nacionales adoptan solo el tamizaje de síntomas, en estas situaciones, la prevalencia estimada de TB podría ser subestimada (9) .…”

Section: Discussionunclassified

“…Otro estudio realizado en la provincia de Xinjiang en China (2010-2011) (15) utilizó como estrategia de tamizaje la presencia de tos o producción de esputo por dos o más semanas y/o hemoptisis, y anormalidad en radiografía de tórax, encontrando una proporción de 5,4%. Por otro lado, en Etiopia (2010-2011) (11) y Zambia (2013-2014) (12) se encontró una proporción de tos de ≥2 semanas de duración del 36,0 y 55,3%, respectivamente; dichos hallazgos se deberían a la elevada incidencia Sintomáticos respiratorios en Perú. ENDES 2013 acumulada de TB de ambos países (192 y 300 casos por cada 100 000 habitantes, respectivamente, en el año 2015) (1) .…”

Section: Discussionunclassified

Prevalencia de sintomáticos respiratorios en población peruana de 15 a más años: análisis secundario de la Encuesta Demográfica y de Salud Familiar, 2013 – 2015

Gutiérrez

Roque

Romaní

et al. 2017

Rev Peru Med Exp Salud Publica

View full text Add to dashboard Cite

2,8% a 3,9%), 3,8% el 2014 (IC95%: 3,5% a 4,1%) y 3,3% el 2015 (IC95% de 3,0 a 3,6%). La prevalencia de SR fue mayor al 5% en personas de 60 a más años, en población de los quintiles más pobres y en residentes de zonas rurales. Concluimos que entre tres a cuatro de cada cien peruanos de 15 a más años se reporta tos con flema de ≥15 días. La proporción de SR varía según región del país. Se recomienda evaluar y ajustar la meta de sintomáticos respiratorios esperados para los establecimientos de salud del Perú.Palabras clave: Tos; Tuberculosis; Perú; prevalencia (fuente: DeCS BIREME). PREVALENCE OF SYMPTOMATIC RESPIRATORY CASES IN THE PERUVIAN POPULATION AGED 15 YEARS AND ABOVE: SECONDARY ANALYSIS OF THE DEMOGRAPHIC AND FAMILY HEALTH SURVEY, 2013-2015 ABSTRACTThe objective of this study was to estimate the prevalence of symptomatic respiratory (SR) cases in the Peruvian population aged 15 years and over between 2013 and 2015. A secondary analysis of the Demographic and Family Health Survey (ENDES) was carried out. The subjects of the study were people aged 15 years and over who answered these interview questions: Do you currently have a cough with phlegm? How long have you had a cough with phlegm? People who had had a cough and phlegm for 15 days or more were defined as having SR. The prevalence of SR was 3.3% in 2013 (95% confidence interval [95% CI]: 2.8-3.9%), 3.8% in 2014 (95% CI: 3.5-4.1%), and 3.3% in 2015 (95% CI: 3.0-3.6%). The prevalence of SR was greater than 5% in people aged 60 years and over, in people in the poorest quintile, and in residents of rural areas. We conclude that 3-4% of Peruvian people aged 15 years and over report cough with phlegm for ≥15 days. The proportion with SR varies according to the region of the country. It is recommended that the expected number of symptomatic SR cases be assessed and that Peruvian healthcare be adjusted as necessary.

show abstract

Patient Preferences for Strategies to Improve Tuberculosis Diagnostic Services in Zambia

et al. 2022

View full text Add to dashboard Cite

IMPORTANCE Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes. OBJECTIVE To assess whether patients with TB have differential preferences for strategies to improve the public health reach of TB diagnostic services. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study was undertaken in which a discrete choice experiment (DCE) was administered between September 18, 2019, and January 17, 2020, to 401 adults (>18 years of age) with microbiologically confirmed TB in Lusaka, Zambia. The DCE had 7 attributes with 2 to 3 levels per attribute related to TB service enhancements. Latent class analysis was used to identify segments of participants with unique preferences. Multiscenario simulations were used to estimate shares of preferences for different TB service improvement strategies. MAIN OUTCOMES AND MEASURESThe main outcomes were patient preference archetypes and estimated shares of preferences for different strategies to improve TB diagnostic services. Collected data were analyzed between January 3, 2022, to July 2, 2022. RESULTS Among 326 adults with TB (median [IQR] age, 34 [27-42] years; 217 [66.8%] male; 158 [48.8%] HIV positive), 3 groups with distinct preferences for TB service improvements were identified. Group 1 (192 participants [58.9%]) preferred a facility that offered same-day TB test results, shorter wait times, and financial incentives for testing. Group 2 (83 participants [25.4%])preferred a facility that provided same-day TB results, had greater privacy, and was closer to home. Group 3 (51 participants [15.6%]) had no strong preferences for service improvements and had negative preferences for receiving telephone-based TB test results. Groups 1 and 2 were more likely to report at least a 4-week delay in seeking health care for their current TB episode compared with group 3 (29 [51.3%] in group 1, 95 [35.8%] in group 2, and 10 [19.6%] in group 3; P < .001). Strategies to improve TB diagnostic services most preferred by all participants were same-day TB test results alone (shares of preference, 69.9%) and combined with a small financial testing incentive (shares of preference, 79.3%), shortened wait times (shares of preference, 76.1%), or greater privacy (shares of preference, 75.0%). However, the most preferred service improvement strategies differed substantially by group. CONCLUSIONS AND RELEVANCEIn this study, patients with TB had heterogenous preferences for TB diagnostic service improvements associated with differential health care-seeking behavior.Tailored strategies that incorporate features most valued by persons with undiagnosed TB, including same-day results, financial incentives, and greater privacy, may optimize reach by overcoming key barriers to timely TB care engagement.

show abstract

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

Cited by 83 publications

References 9 publications

The prevalence of HIV among adults with pulmonary TB at a population level in Zambia

The prevalence of HIV among adults with pulmonary TB at a population level in Zambia

Prevalencia de sintomáticos respiratorios en población peruana de 15 a más años: análisis secundario de la Encuesta Demográfica y de Salud Familiar, 2013 – 2015

Patient Preferences for Strategies to Improve Tuberculosis Diagnostic Services in Zambia

Contact Info

Product

Resources

About