Epidemiological trends in tuberculosis during a technical assistance project, Lusaka, Zambia, 2018-2021

Five health facilities in Lusaka, Zambia.

An observational study to describe activities of a technical assistance project in 2019-2021 with baseline epidemiological indicators in 2018.

The number of presumptive tuberculosis (TB) cases at the five sites significantly rose from 7,063 in 2018 to 48,250 in 2021 with a total diagnosis of 9,642 cases of all types of TB and 4,747 cases of bacteriologically positive TB in the 4 years. The percentage of the bacteriologically positive cases among the presumptive TB ones varied from 8.2% to 11.3% in facilities. The proportion of bacteriologically positive TB among the presumptive TB cases at five sites declined from 14.1% in 2018-2019 to 8.3% in 2020-2021 (P < 0.001). Treatment success rates maintained high over 85% in four facilities, whereas in the other improved significantly. The 'not evaluated' rates of treatment outcomes dropped from 7.0% at all the facilities in 2018-2019 to 1.0% in 2020. During the project, three GeneXpert and a digital X-ray machines were installed in the facilities.

Investment in TB, particularly in diagnostic tools, and training of health care workers, coupled with close monitoring of health workers and community volunteers, can greatly improve core TB indicators.