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

@article{mwaba2026scalingup,
  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}},
  author = {Phallon Blessing Mwaba and Innocent Mwaba and Minyoi Mubita Maimbolwa and Chitalu Chanda and Muhammad Mputu and Chola Lumbwe and Kevin Zimba and Nancy Kasese Chanda and Rhehab Chimzizi and Angel Mubanga and Monde Muyoyeta and Mary Kagujje},
  journal = {PLOS Global Public Health},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pgph.0005628},
  url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005628},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - 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
AU  - Phallon Blessing Mwaba
AU  - Innocent Mwaba
AU  - Minyoi Mubita Maimbolwa
AU  - Chitalu Chanda
AU  - Muhammad Mputu
AU  - Chola Lumbwe
AU  - Kevin Zimba
AU  - Nancy Kasese Chanda
AU  - Rhehab Chimzizi
AU  - Angel Mubanga
AU  - Monde Muyoyeta
AU  - Mary Kagujje
PY  - 2026
DA  - 2026/09/18
JO  - PLOS Global Public Health
DO  - 10.1371/journal.pgph.0005628
UR  - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005628
AB  - 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.
SN  - 2767-3375
ER  -