By : P Lungu
Citation Style For This Article: Lungu P. TB Situation in Zambia, the Progress made in the fighting the scourge.Health Press Zambia Bull. 2022; 06(1); pp 1.
Zambia is among the 30 high TB and TB-HIV burden countries. TB in Zambia TB remains a major cause of ill-health and deaths especially among people living with HIV (PLHIV). In our setting, TB alone is responsible for at least 40% of the deaths among people living with HIV in Zambia.
The World Health Organization in 2022 estimated the TB incidence to be at 307 per 100,000 a drop from 346 per 100,000 population. overall, this represents a 60% reduction in the burden of TB in Zambia when compared with the level in 2000 (759/100,000 population).
In the last 5 years, Zambia has amplified and accelerated the fight against TB. In the last 5 years there has been huge capital investment from both donor and domestic funding through the donor community and the Government of the Republic of Zambia.
As this unprecedented capital investment, the country has made tremendous progress in the fight against TB, for instance:
As mentioned above, Zambia has achieved a 60% reduction in the burden of TB over the last 2 decades
TB related deaths have reduced by 65% in 2022 when compared to 2015. The mortality rate in 2015 was estimated to be 115/100,000 while in 2021 the TB mortality rate stood at 40/100,000.
TB infections rate among PLHIV has reduced from 60% in 2018 to 34% in 2022
The country has accelerated the detection of TB among the vulnerable population, in children for instance, TB case detection has increase by at least 2 fold. We now stand 9% of all the cases of TB being in children. Almost achieving the WHO bench mark of 10% case contribution by childhood TB.
The treatment success rate of drug sensitive TB has been sustained at over 90%
There has been an improvement of the treatment success rate of Drug resistant TB from only 33% in 2012 to now 76% in 2022.
TB treatment coverage has increased from 58% in 2018 to 85% in 2022, meaning in 2018, Zambia was only detection and treating 58% of the estimated incident cases and now is detecting and treating 85% of the estimated new cases of TB.
Over 90% of PLHIV have received and completed successfully the lifesaving and TB preventive therapy/prophylaxis.
Partly, to explain this steady and significant progress made by the country, the Ministry of Health and its partners, placed sensitive and state of the art TB diagnostic tools. We now have 7 mobile TB trucks revolving around the various communities in the country including the hard to reach places. The Ministry of Health has over the years built the necessary competencies in the diagnosis of TB including the most complex forms.
While there has been palpable progress in there remains some gaps; 15% of new TB cases are not reached and treated, 55% of children exposed to TB patients are not provided the much-needed TB preventive therapy, stigma to TB, myths and misconceptions remains rife, knowledge level about TB by the public remains low. At present the TB laboratory diagnostic network can only readily meet the needs of 66% of the population with the 20Km radius, meaning. Meaning 44% are accessing TB diagnostic services by referral to nearby facilities.
Going forward the preoccupation of the Ministry of Health under the National TB and Leprosy programme includes;
Sustain the best practices
Sustain the high TB treatment success rate
Scale up TB case detection throughout the continuum of care starting from community level
Raise the much-needed TB awareness and create demand
A message for the public;
TB remains among us,
TB kills those that delay or don’t access TB services
Everyone is at risk of TB
When one has any of the following symptoms; cough, fever, chest pains, night sweats, poor appetite, weight loss unexplained ill health, reduced playfulness in children, they should immediately seek health care from the nearest health facility for TB screening and diagnosis.
TB can be prevented using by maintaining good ventilation, observing cough etiquette by the affected, taking TB preventive therapy/prophylaxis when prescribed by a health care worker.
Take home message is that TB is both preventable and curable.