{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:47:28Z","timestamp":1792730848429,"version":"4.5.0"},"reference-count":61,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T00:00:00Z","timestamp":1602460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective and methods<\/jats:title><jats:p>Worldwide, tuberculosis (TB) is the leading cause of death from a single infectious agent. In many countries, national TB prevalence surveys are the only way to reliably measure the burden of TB disease and can also provide other evidence to inform national efforts to improve TB detection and treatment. Our objective was to synthesise the results and lessons learned from national surveys completed in Africa between 2008 and 2016, to complement a previous review for Asia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve surveys completed in Africa were identified: Ethiopia (2010\u20132011), Gambia (2011\u20132013), Ghana (2013), Kenya (2015\u20132016), Malawi (2013\u20132014), Nigeria (2012), Rwanda (2012), Sudan (2013\u20132014), Tanzania (2011\u20132012), Uganda (2014\u20132015), Zambia (2013\u20132014) and Zimbabwe (2014). The eligible population in all surveys was people aged \u226515\u00a0years who met residency criteria. In total 588\u00a0105 individuals participated, equivalent to 82% (range 57\u201396%) of those eligible. The prevalence of bacteriologically confirmed pulmonary TB disease in those \u226515\u00a0years varied from 119 (95% CI 79\u2013160) per 100\u00a0000 population in Rwanda and 638 (95% CI 502\u2013774) per 100\u00a0000 population in Zambia. The male:female ratio was 2.0 overall, ranging from 1.2 (Ethiopia) to 4.1 (Uganda). Prevalence per 100\u00a0000 population generally increased with age, but the absolute number of cases was usually highest among those aged 35\u201344\u00a0years. Of identified TB cases, 44% (95% CI 40\u201349) did not report TB symptoms during screening and were only identified as eligible for diagnostic testing due to an abnormal chest X\u2010ray. The overall ratio of prevalence to case notifications was 2.5 (95% CI 1.8\u20133.2) and was consistently higher for men than women. Many participants who did report TB symptoms had not sought care; those that had were more likely to seek care in a public health facility. HIV prevalence was systematically lower among prevalent cases than officially notified TB patients with an overall ratio of 0.5 (95% CI 0.3\u20130.7). The two main study limitations were that none of the surveys included people &lt;15\u00a0years, and 5 of 12 surveys did not have data on HIV status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>National TB prevalence surveys implemented in Africa between 2010 and 2016 have contributed substantial new evidence about the burden of TB disease, its distribution by age and sex, and gaps in TB detection and treatment. Policies and practices to improve access to health services and reduce under\u2010reporting of detected TB cases are needed, especially among men. All surveys provide a valuable baseline for future assessment of trends in TB disease burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13485","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T08:05:14Z","timestamp":1601193914000},"page":"1308-1327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["National tuberculosis prevalence surveys in Africa, 2008\u20132016: an overview of results and lessons learned"],"prefix":"10.1111","volume":"25","author":[{"given":"Irwin","family":"Law","sequence":"first","affiliation":[{"name":"Global Tuberculosis Programme World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Floyd","sequence":"additional","affiliation":[{"name":"Global Tuberculosis Programme World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the African TB Prevalence Survey Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,12]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Global Tuberculosis Report","author":"World Health Organization","year":"2019"},{"key":"e_1_2_7_3_1","unstructured":"United Nations.Millennium development goals. (Available from:http:\/\/www.un.org\/millenniumgoals\/) [10 Dec 2018]."},{"key":"e_1_2_7_4_1","volume-title":"The Global Plan to Stop TB, 2006\u20132015: Actions for Life Towards a World Free of Tuberculosis","author":"World Health Organization","year":"2006"},{"key":"e_1_2_7_5_1","volume-title":"The Stop TB Strategy","author":"World Health Organization","year":"2006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12534"},{"key":"e_1_2_7_7_1","unstructured":"World Health Organization.Technical appendix on methods used to estimate the global burden of disease caused by TB 2017. (Available from:http:\/\/www.who.int\/tb\/publications\/global_report\/en\/) [10 Dec 2018]."},{"key":"e_1_2_7_8_1","unstructured":"World Health Organization.WHO Global Task Force on TB Impact Measurement Geneva Switzerland. (Available from:https:\/\/www.who.int\/tb\/areas-of-work\/monitoring-evaluation\/impact_measurement_taskforce\/en\/) [12 June 2019]."},{"key":"e_1_2_7_9_1","volume-title":"Tuberculosis Prevalence Surveys: A Handbook","author":"World Health Organization","year":"2011"},{"key":"e_1_2_7_10_1","first-page":"459","article-title":"Tuberculosis in tropical Africa. An Epidemiological Study","volume":"30","author":"Roelsgaard E","year":"1964","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.2471\/BLT.06.038604","article-title":"Determining the burden of tuberculosis in Eritrea: a new approach","volume":"85","author":"Sebhatu M","year":"2007","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005602"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0058689"},{"key":"e_1_2_7_14_1","first-page":"1231","article-title":"Prevalent infectious tuberculosis in Harare, Zimbabwe: burden, risk factors and implications for control","volume":"13","author":"Corbett EL","year":"2009","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201008-1269OC"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.13.131581"},{"key":"e_1_2_7_17_1","first-page":"1224","article-title":"Significant decline in the tuberculosis burden in the Philippines ten years after initiating DOTS","volume":"13","author":"Tupasi TE","year":"2009","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62639-2"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.2471\/BLT.14.151670","article-title":"A tuberculosis nationwide prevalence survey in Gambia, 2012","volume":"94","author":"Adetifa IM","year":"2016","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209098"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146392"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.5588\/ijtld.13.0417","article-title":"The first population\u2010based national tuberculosis prevalence survey in Ethiopia, 2010\u20132011","volume":"18","author":"Kebede AH","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.15.0340"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.5588\/ijtld.19.0163","article-title":"National population\u2010based tuberculosis prevalence survey in Ghana, 2013","volume":"24","author":"Bonsu F","year":"2020","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231372"},{"key":"e_1_2_7_26_1","unstructured":"Department of Public Health Federal Republic of Nigeria.Report of the first national TB prevalence survey 2012 Nigeria 2014."},{"key":"e_1_2_7_27_1","unstructured":"Ministry of Health.Technical report of the Zambia national tuberculosis prevalence survey (2013\u20132014).2015."},{"key":"e_1_2_7_28_1","volume-title":"First Ethiopian National Population Based Tuberculosis Prevalence Survey","author":"Ministry of Health \u2013 Federal Democratic Republic of Ethiopia","year":"2011"},{"key":"e_1_2_7_29_1","unstructured":"Ministry of Health (national tuberculosis leprosy and lung disease program).National tuberculosis prevalence survey of Kenya 2015\u20132016.2016."},{"key":"e_1_2_7_30_1","unstructured":"Ministry of Health (national tuberculosis program).National tuberculosis prevalence survey of Sudan 2013\u20132014 (report).2018."},{"key":"e_1_2_7_31_1","unstructured":"Ministry of Health and Child Care.The Zimbabwe National Population based Tuberculosis Prevalence Survey.2014."},{"key":"e_1_2_7_32_1","unstructured":"Ministry of Health and Social Welfare.The first national tuberculosis prevalence survey in the United Republic of Tanzania.2013."},{"key":"e_1_2_7_33_1","volume-title":"The Gambian Survey of Tuberculosis Prevalence Report","author":"Ministry of Health and Social Welfare","year":"2014"},{"key":"e_1_2_7_34_1","unstructured":"Ministry of Health National TB Control Programme.Technical report: Malawi tuberculosis prevalence survey (2013\u20132014).2016."},{"key":"e_1_2_7_35_1","volume-title":"Ministry of Health Uganda and Makerere University School of Public Health","author":"Makerere University School of Public Health","year":"2016"},{"key":"e_1_2_7_36_1","unstructured":"National TB Control Programme (Ghana Health Service).Ghanaian national population based tuberculosis prevalence survey in 2013 (report).2016."},{"key":"e_1_2_7_37_1","unstructured":"Rwanda Ministry of Health.The first national tuberculosis prevalence survey in Rwanda (2012).2015."},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-7622-10-10"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014"},{"key":"e_1_2_7_40_1","unstructured":"World Health Organization.Global Tuberculosis Database 2018. (Available from:http:\/\/www.who.int\/tb\/country\/en\/) [10 Dec 2018]."},{"key":"e_1_2_7_41_1","unstructured":"United Nations Population Division.World Population Prospects 2015. (Available from:http:\/\/esa.un.org\/unpd\/wpp\/) [10 Dec 2018]."},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_7_44_1","unstructured":"World Health Organization.Laboratory Services in Tuberculosis Control.1999."},{"key":"e_1_2_7_45_1","volume-title":"Policy Statement: Liquid Media for Culture and DST","author":"World Health Organization","year":"2007"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.3.1101-1108.2003"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163975"},{"key":"e_1_2_7_48_1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.5588\/ijtld.14.0499","article-title":"Health care\u2010seeking behaviour among people with cough in Tanzania: findings from a tuberculosis prevalence survey","volume":"19","author":"Senkoro M","year":"2015","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_49_1","unstructured":"Rwanda Ministry of Health.The first national tuberculosis prevalence survey in Rwanda (2012).2015."},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68392-X"},{"key":"e_1_2_7_51_1","volume-title":"Global Tuberculosis Report","author":"World Health Organization","year":"2017"},{"key":"e_1_2_7_52_1","volume-title":"WHO Policy on Collaborative TB\/HIV Activities Guidelines for National Programmes and Other Stakeholders","author":"World Health Organization","year":"2012"},{"key":"e_1_2_7_53_1","unstructured":"World Health Organization.Systematic Screening for Active Tuberculosis: Principles and Recommendations.2013."},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12306"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30215-8"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1264-6"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1009.040349"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002119"},{"key":"e_1_2_7_59_1","volume-title":"Assessing Tuberculosis Under\u2010Reporting Through Inventory Studies","author":"World Health Organization","year":"2014"},{"key":"e_1_2_7_60_1","volume-title":"Handbook of Child and Adolescent Tuberculosis","author":"Starke JR","year":"2016"},{"key":"e_1_2_7_61_1","unstructured":"United Nations.Sustainable Development Goals. (Available from:https:\/\/www.un.org\/sustainabledevelopment\/) [10 Dec 2018]."},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60570-0"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13485","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13485","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13485","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T07:10:11Z","timestamp":1693811411000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,12]]},"references-count":61,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/tmi.13485"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13485","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,12]]},"assertion":[{"value":"2020-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}