{
  "abstract": "While tuberculosis preventive therapy (TPT) coverage among people living with HIV in Zambia has improved, uptake among HIV-negative contacts aged ≥5 years remains low. Despite evidence showing that TPT can reduce TB incidence by up to 60% in HIV-negative individuals, there is a paucity of evidence on programmatic rollout to this population in Zambia and the region. We present programme data from a TPT surge aimed at increasing uptake among ≥5 years old HIV-negative household TB contacts. The National TB Programme, with support from the TB Local Organizations Network, conducted a TPT surge in 89 high TB-burden facilities across eight project supported provinces in Zambia from October 2024–15th January 2025. After a thorough planning phase, multidisciplinary teams conducted field visits for contact tracing and initiated TPT for eligible household contacts of bacteriologically confirmed TB.. Facility-based TPT initiation was provided for walk-in clients. We collected and analyzed aggregate data from facility registers. A total of 19,371 HIV-negative contacts aged ≥ 5 years were screened: 99.9% (n = 19,344) were eligible for and offered TPT. Of these, 72.4% (n = 14,000) were initiated on TPT, 2.0% (n = 385) refused and 26.2% (n = 4,959) were not initiated on treatment due to unavailability of their preferred regimen. The start of the surge was associated with an immediate 47.7% points increase in TPT coverage (p = 0.001). Overall, 63.7% (n = 8,917) were initiated on three-months Isoniazid+Rifapentine, followed by six-months Isoniazid (30.2%, n = 4226); one-month Isoniazid+Rifapentine (4.5%, n = 625) and on three-months Isoniazid+Rifampicin (1.7%, n = 232). The surge demonstrated that TPT can be rolled out to ≥5 years old HIV-negative TB contacts with high initiation rates achieved. This is achievable through targeted implementation, stakeholder engagement, and community-driven approaches. These findings underscore the feasibility of extending TPT to all TB contacts, regardless of HIV status or age, to accelerate TB prevention efforts in high-burden settings like Zambia.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Tuberculosis and other Respiratory Diseases, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia",
    "Department of Public Health, National Tuberculosis and Leprosy Programme, Ministry of Health, Lusaka, Zambia",
    "Department of Health Management and Health Economics, University of Oslo, Oslo, Norway",
    "The Health Coordination Office, United States Embassy, Lusaka, Zambia"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Phallon Blessing Mwaba"
    },
    {
      "affs": [
        1
      ],
      "name": "Innocent Mwaba"
    },
    {
      "affs": [
        2
      ],
      "name": "Minyoi Mubita Maimbolwa"
    },
    {
      "affs": [
        3
      ],
      "name": "Chitalu Chanda"
    },
    {
      "name": "Muhammad Mputu"
    },
    {
      "name": "Chola Lumbwe"
    },
    {
      "name": "Kevin Zimba"
    },
    {
      "name": "Nancy Kasese Chanda"
    },
    {
      "name": "Rhehab Chimzizi"
    },
    {
      "name": "Angel Mubanga"
    },
    {
      "name": "Monde Muyoyeta"
    },
    {
      "name": "Mary Kagujje"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ct7xe65ptcwa1.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pgph.0005628",
  "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005628",
  "id": "ct7xe65ptcwa1",
  "issns": [
    "2767-3375"
  ],
  "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005628",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Tuberculosis diagnosis and management"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health care facilities"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Bacterial diseases/Tuberculosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Tropical diseases/Tuberculosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmacology/Drugs/Isoniazid"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Africa/Zambia"
    ],
    [
      "plos",
      "/Physical sciences/Mathematics/Statistics/Statistical methods/Time series analysis"
    ],
    [
      "plos",
      "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Time series analysis"
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  "openalex": "W7213552951",
  "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0005628&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-18",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/ct7xe65ptcwa1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:49Z",
      "native_id": "10.1371/journal.pgph.0005628",
      "source": "plos",
      "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005628"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:microbiology",
      "subfield": "microbiology"
    },
    {
      "field": "mathematics",
      "origin": "plos:statistical methods",
      "subfield": "statistics"
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    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Scaling-up tuberculosis preventive therapy to HIV-negative contacts of bacteriologically confirmed TB cases aged 5 years and above – Lessons from a tuberculosis preventive therapy surge activity in Zambia",
  "title_text": "Scaling-up tuberculosis preventive therapy to HIV-negative contacts of bacteriologically confirmed TB cases aged 5 years and above – Lessons from a tuberculosis preventive therapy surge activity in Zambia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:49Z",
  "url": "https://research.draconitic.com/paper/ct7xe65ptcwa1",
  "venue": "PLOS Global Public Health",
  "versions": []
}