Tuberculosis in Zambia Defining the status quo and assessing ways to improve prevention, diagnosis and service delivery

Tuberculosis in Zambia, like in many sub-Saharan African Countries, is a major cause of morbidity and mortality. This study was conducted to define the actual tuberculosis burden in Zambia, including TB/HIV co-infections and drug-resistant tuberculosis; thereby defining the status quo in order to facilitate the identification of strategies to be applied and implemented so as to meet the global targets for TB control. A mixed method approach was applied through, retrospective reviews, cross-sectional studies, anthropological and cohort studies. The burden of TB was therefore defined in terms of trends based on programmatic notification data that indicated a decline in trends over the years; childhood TB diagnosis and treatment was highlighted to be problematic and it was found that although progress had been made in the implementation of TB/HIV collaborative activities leading to improved treatment outcomes and low level of multidrug resistant TB, there was still much to be done. The population based national TB prevalence survey highlighted that the TB burden was higher than was previously estimated and therefore new innovations and strategies were required in order to detect and effectively treat the missed cases. It was also found that socio-economic factors, poverty and stigma had a negative impact and there was a lot of gaps in management of drug-resistant TB patients with a lot of them being lost to follow-up even before treatment was instituted. There is urgent need to improve diagnostic capacity and the general health care system in order to improve on the status quo.