Browsing by Author "Maimbolwa MM"

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    Knowledge, attitudes, and practices towards childhood tuberculosis among healthcare workers at two primary health facilities in Lusaka, Zambia.
    (2024) Kaumba PC; Siameka D; Kagujje M; Chungu C; Nyangu S; Sanjase N; Maimbolwa MM; Shuma B; Chilukutu L; Muyoyeta M
    BACKGROUND: Zambia is among the 30 high-burden countries for tuberculosis (TB), Human Immunodeficiency Virus (HIV)-associated TB, and multi-drug resistant/rifampicin resistant TB with over 5000 children developing TB every year. However, at least 32% of the estimated children remain undiagnosed. We assessed healthcare workers' (HCWs) knowledge, attitudes, and practices (KAP) towards childhood TB and the factors associated with good KAP towards childhood TB. METHODS: Data was collected at two primary healthcare facilities in Lusaka, Zambia from July to August 2020. Structured questionnaires were administered to HCWs that were selected through stratified random sampling. Descriptive analysis was done to determine KAP. A maximum knowledge, attitude, and practice scores for a participant were 44, 10, and 8 points respectively. The categorization as either "poor" or "good" KAP was determined based on the mean/ median. Logistic regression analysis was performed to assess the associations between participant characteristics and KAP at statistically significant level of 0.05%. RESULTS: Among the 237 respondents, majority were under 30 years old (63.7%) and were female (72.6%). Half of the participants (50.6%) were from the outpatient department (OPD) and antiretroviral therapy (ART) clinic, 109 (46.0) had been working at the facility for less than 1 year, 134 (56.5%) reported no previous training in TB. The median/mean KAP scores were 28 (IQR 24.0-31.0), 7 (IQR = 6.0-8.0) and 5 points (SD = 1.9) respectively. Of the participants, 43.5% (103/237) had good knowledge, 48.1% (114/237) had a good attitude, and 54.4% (129/237) had good practice scores on childhood TB. In the multivariate analysis, clinical officers and individuals with 1-5 years' work experience at the facility had higher odds, 2.61 (95% CI = 1.18-5.80, p = 0.018) and 3.09 (95% CI = 1.69-5.65, p = 0.001) of having good attitude respectively, and medical doctors had 0.17 lower odds (95% CI = 0.18-5.80, p = 0.018) of good childhood TB practice. Other participant characteristics didn't show a significant association with the scores. CONCLUSION: The study found suboptimal levels of knowledge, attitude, and practices regarding childhood TB among HCWs. Targeted programmatic support needs to be provided to address the above gaps.
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    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.
    (2026) Mwaba PB; Mwaba I; Maimbolwa MM; Chanda C; Mputu M; Lumbwe C; Zimba K; Chanda NK; Chimzizi R; Mubanga A; Muyoyeta M; Kagujje M
    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.