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Lusaka, Zambia

Chanda-Kapata P.,Control and Research | Chanda-Kapata P.,University of Amsterdam | Kapata N.,University of Amsterdam | Klinkenberg E.,KNCV Tuberculosis Foundation | And 7 more authors.
AIDS Research and Therapy | Year: 2016

Objective: To estimate the adult prevalence of HIV among the adult population in Zambia and determine whether demographic characteristics were associated with being HIV positive. Methods: A cross sectional population based survey to asses HIV status among participants aged 15years and above in a national tuberculosis prevalence survey. Counselling was offered to participants who tested for HIV. The prevalence was estimated using a logistic regression model. Univariate and multivariate associations of social demographic characteristics with HIV were determined. Results: Of the 46,099 individuals who were eligible to participate in the survey, 44,761 (97.1%) underwent pre-test counselling for HIV; out of which 30,605 (68.4%) consented to be tested and 30, 584 (99.9%) were tested. HIV prevalence was estimated to be 6.6% (95% CI 5.8-7.4); with females having a higher prevalence than males 7.7% (95% CI 6.8-8.7) versus 5.2% (95% CI 4.4-5.9). HIV prevalence was higher among urban (9.8%; 95% CI 8.8-10.7) than rural residents (5.0%; 95% CI 4.3-5.8). The risk of HIV was double among urban dwellers than among their rural counterparts. Being divorced or widowed was associated with a threefold higher risk of being HIV positive than being never married. The risk of being HIV positive was four times higher among those with tuberculosis than those without tuberculosis. Conclusions: HIV prevalence was lower than previously estimated in the country. The burden of HIV showed sociodemographic disparities signifying a need to target key populations or epidemic drivers. Mobile testing for HIV on a national scale in the context of TB prevalence surveys could be explored further in other settings. © 2016 Chanda-Kapata et al.

Chanda-Kapata P.,Control and Research | Chanda-Kapata P.,University of Amsterdam | Ngosa W.,Control and Research | Moraes A.N.,Control and Research | And 2 more authors.
Asian Pacific Journal of Tropical Biomedicine | Year: 2015

Objective: To assess the prevalence of HIV infection, to highlight HIV-testing refusal rates among participants in a population-based tuberculosis survey and to assess the implication for programme implementation. Methods: This cross-sectional study on the characteristics of participants who refused HIV testing was conducted in a national survey in Zambia. All eligible participants were aged above 15 years and included in the analysis. Results: Out of the 44 791 tuberculosis survey participants, 14 164 (31.6%) refused to participate in HIV testing. The unemployed, rural dwellers, married, and those aged 15- 24 years were associated with higher refusal rates. Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented. © 2015 Hainan Medical University.

Chanda-Kapata P.,Control and Research | Chanda-Kapata P.,University of Amsterdam | Kapata N.,University of Amsterdam | Klinkenberg E.,KNCV Tuberculosis Foundation | And 7 more authors.
BMC Infectious Diseases | Year: 2015

Background: Non-tuberculous mycobacteria (NTM) infection is an emerging health problem. We present here the Zambia-specific national level data of prevalence, symptomatic, radiological and microbiological characteristics of NTM, using results from a national Tuberculosis (TB) prevalence survey. Methods: This was a cross-sectional study of the prevalence of NTM among adults aged 15years and above, who were participants in a national TB prevalence survey. Participants who had either an abnormal chest x-ray or were symptomatic were considered presumptive TB cases and submitted sputum for smear and culture analysis. HIV testing was performed on an opt-out basis. Symptomatic NTM prevalence was estimated from individual level analysis. Results: Of the 6,123 individuals with presumptive TB, 923 (15.1%) were found to have NTM, 13 (0.2%) were MTB/NTM co-infected and 338 (5.5%) were contaminated (indeterminate). The prevalence of symptomatic NTM was found to be 1,477/100,000 [95% CI 1010-1943]. Smear positivity, history of cough or chest pain and HIV positivity were risk factors for NTM. Conclusion: This first study to estimate the national prevalence of NTM in Zambia indicates that the burden is high. The NTM occurrence in Zambia constitutes both a public health and ethical issue requiring action from health managers. © 2015 Chanda-Kapata et al.

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