Abstract
BackgroundNon-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.MethodsThis was a cross-sectional study of the prevalence of NTM among adults aged 15 years 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.ResultsOf 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.ConclusionThis 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.
Highlights
Non-tuberculous mycobacteria (NTM) infection is an emerging health problem
Among the diseases caused by NTM, pulmonary disease is the most frequent, followed by lymphadenitis in children, skin disease caused by Mycobacterium marinum and other extra-pulmonary or disseminated infections [3, 5, 7]
A recent study in Nigeria [12] showed that failure to characterize acid-fast bacilli (AFB) positive NTM lung infections has led to misclassification and incorrect treatment as pulmonary tuberculosis since all diagnosed sputum smear positive patients are placed on TB treatment
Summary
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. Non-tuberculosis Mycobacteria (NTM) refer to all Mycobacterium species other than the pathogens of the M.tuberculosis complex (MTBC), M. leprae and M. ulcerans, and rarely cause disease in humans. NTM can exhibit clinical and radiographic features that are similar to those by MTBC [8, 9] especially in persons with progressed cellular immune dysfunction. This is not the case in all studies, in Brazil, Dos Santos. In order to differentiate the two, traditional culture methods may be required but these may take up to 6 weeks [13]
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