{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:09:49Z","timestamp":1789754989593,"version":"4.0.1"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"USAID Zambia","award":["72061120CA00001"],"award-info":[{"award-number":["72061120CA00001"]}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>\n                    While tuberculosis preventive therapy (TPT) coverage among people living with HIV in Zambia has improved, uptake among HIV-negative contacts aged \u22655 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 \u22655 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\u201315\n                    <jats:sup>th<\/jats:sup>\n                    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\u2009\u2265\u20095 years were screened: 99.9% (n\u2009=\u200919,344) were eligible for and offered TPT. Of these, 72.4% (n\u2009=\u200914,000) were initiated on TPT, 2.0% (n\u2009=\u2009385) refused and 26.2% (n\u2009=\u20094,959) 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\u2009=\u20090.001). Overall, 63.7% (n\u2009=\u20098,917) were initiated on three-months Isoniazid+Rifapentine, followed by six-months Isoniazid (30.2%, n\u2009=\u20094226); one-month Isoniazid+Rifapentine (4.5%, n\u2009=\u2009625) and on three-months Isoniazid+Rifampicin (1.7%, n\u2009=\u2009232). The surge demonstrated that TPT can be rolled out to \u22655 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.\n                  <\/jats:p>","DOI":"10.1371\/journal.pgph.0005628","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:43:38Z","timestamp":1789753418000},"page":"e0005628","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Scaling-up tuberculosis preventive therapy to HIV-negative contacts of bacteriologically confirmed TB cases aged 5 years and above \u2013 Lessons from a tuberculosis preventive therapy surge activity in Zambia"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3275-4934","authenticated-orcid":true,"given":"Phallon Blessing","family":"Mwaba","sequence":"first","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia","place":["Lusaka, Zambia"],"department":["Department of Tuberculosis and other Respiratory Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Mwaba","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia","place":["Lusaka, Zambia"],"department":["Department of Tuberculosis and other Respiratory Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minyoi Mubita","family":"Maimbolwa","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia","place":["Lusaka, Zambia"],"department":["Department of Tuberculosis and other Respiratory Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1186-5045","authenticated-orcid":true,"given":"Chitalu","family":"Chanda","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Leprosy Programme, Ministry of Health","place":["Lusaka, Zambia"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Mputu","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Leprosy Programme, Ministry of Health","place":["Lusaka, Zambia"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chola","family":"Lumbwe","sequence":"additional","affiliation":[{"name":"University of Oslo","place":["Oslo, Norway"],"department":["Department of Health Management and Health Economics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Zimba","sequence":"additional","affiliation":[{"name":"The Health Coordination Office, United States Embassy","place":["Lusaka, Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-8043","authenticated-orcid":true,"given":"Nancy Kasese","family":"Chanda","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Leprosy Programme, Ministry of Health","place":["Lusaka, Zambia"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhehab","family":"Chimzizi","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Leprosy Programme, Ministry of Health","place":["Lusaka, Zambia"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Mubanga","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Leprosy Programme, Ministry of Health","place":["Lusaka, Zambia"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monde","family":"Muyoyeta","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia","place":["Lusaka, Zambia"],"department":["Department of Tuberculosis and other Respiratory Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-6548","authenticated-orcid":true,"given":"Mary","family":"Kagujje","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia","place":["Lusaka, Zambia"],"department":["Department of Tuberculosis and other Respiratory Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"pgph.0005628.ref001","unstructured":"World Health Organisation. 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