Abstract
background 
 Screening of contacts of TB patients is not routinely done in resource-limited countries like Zambia despite WHO recommendations, leading to missed opportunities for prevention, early diagnosis and high mortality.
 OBJECTIVES 
 Main objective was to establish the prevalence of latent and active tuberculosis in bedside contacts of smear-positive index patients and associated risk factors.
 METHODS 
 We recruited bedside contacts of smear-positive TB patients in medical wards and contacts of surgical patients as a comparison group using a questionnaire to collect data on various variables. Active TB was diagnosed microbiologically and radiologically, while LTBI by TST.
 RESULTS 
 We had 64 TB-unexposed and 70 TB-exposed, with a mean age of 41.2 [±13.5] years and 40.2 [±14.7] years respectively. Prevalence of active TB in the two groups was 10.0% and 0% respectively while that of LTBI was 83.1% and 38.3% respectively. TB exposure was significantly associated with active TB (p=0.014), LTBI (p<0.001) and type of contact (p<0.001)] but not duration of exposure (p=0.057). 
 CONCLUSION 
 Bedside contacts were at increased risk of contracting both latent and active TB. Given the significant burden of LTBI in the general population without documented TB exposure, there is an urgent to institute preventive measures to protect/treat contacts of TB patients.
Highlights
Tuberculosis (TB) remains a significant cause of preventable morbidity and mortality in developing countries
Bedside contacts of active TB patients are at an increased risk of contracting both latent and active TB
Our findings suggest a significant prevalence of Latent TB infection (LTBI) in the general population of Lusaka
Summary
Tuberculosis (TB) remains a significant cause of preventable morbidity and mortality in developing countries. One key highlight of the survey was that participants found with TB during the survey had been to the health facilities two or three times and TB was missed until the survey This highlights the point that TB control remains a challenge due to, among other factors, diagnostic delays., About 41% of TB cases in Zambia are undetected, untreated and continue to infect others driving the TB epidemic. Latent TB infection (LTBI) treatment is an important public health intervention especially among people living with HIV yet the uptake of TB preventive therapy (TPT) remains suboptimal. Screening of contacts of tuberculosis (TB) patients is not routinely done in resourcelimited countries like Zambia despite the World Health Organization (WHO) recommendations, leading to missed opportunities for prevention, early diagnosis and high mortality
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