Trends of Zambia's tuberculosis burden over the past two decades

Trop Med Int Health. 2011 Nov;16(11):1404-9. doi: 10.1111/j.1365-3156.2011.02849.x. Epub 2011 Jul 29.


Objectives: To study trends in Zambia's TB notification rates between 1990 and 2010 and to ascertain progress made towards TB control.

Methods: Retrospective review of TB notification returns and TB programme reports for the period from 1990 to 2010.

Results: Two distinct TB trend periods were identified: a period of rising trends up to a peak between 1990 and 2004 and a period of moderately declining trends between 2004 and 2010. Treatment outcomes improved over the two decades. Data on trends in paediatric TB, TB in prisoners and TB in pregnant women remain scanty and unreliable owing to poor diagnostic capability. There were no data available on trends on drug-resistant TB because of the lack of laboratory services to perform drug sensitivity testing.

Conclusions: The period of increasing TB between 1990 and 2000 coincided with an increase in HIV/AIDS. The period of slightly decreasing TB between 2004 and 2010 can be attributed to improved TB care, sustained DOTS implementation and improvement in TB diagnostic services. Newer diagnostics technologies for the rapid diagnosis of active TB cases and for drug-resistant testing, recently endorsed by the WHO, need to be implemented into the national TB programmes to detect more cases and to provide epidemiological and surveillance data from which to obtain an evidence base for guided investments for TB control. Alignment of TB and HIV services is required to achieve improved management outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Directly Observed Therapy
  • Female
  • Humans
  • Male
  • Population Surveillance / methods
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Retrospective Studies
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology*
  • World Health Organization
  • Zambia / epidemiology


  • Antitubercular Agents