title: Trends of sputum-smear positive tuberculosis in Zimbabwe: 2008-2011.
abstract: BACKGROUND
  Tuberculosis (TB) has remained one of the major public health problems in Zimbabwe with an estimated incidence rate of 552 per 100,000 persons in 2013. The aim of this study was to describe the trends in acid-fast bacilli (AFB) sputum-smear positive (SSP) TB overall and within subpopulations for the period during 2008-2011 in Zimbabwe. Results of this study will contribute towards the evaluation and implementation of targeted TB control interventions.
  
  
  METHODS
  A cross-sectional study design was used to analyze 40, 110 SSP TB patient records routinely collected during 2008-2011. Incidence trends of SSP TB were described by province, sex, and age group. A Mantel-Haenszel Chi Statistic was calculated to compare each provincial SSP TB notification rate to the national SSP TB notification rate.
  
  
  RESULTS
  SSP TB notification rates were higher in the two main urban provinces, the western provinces and Manicaland. The 25-44 year age group accounted for the largest proportion of notified SSP TB. However, the 55-64 year and 65+ age groups had SSP TB notification rates in 2011 higher than the 2008 value. Finally, the average SSP TB notification rate in males was 23% higher than in females.
  
  
  CONCLUSIONS
  The findings of this study suggest that TB control has successfully decreased the notification rate of SSP TB in Zimbabwe during 2008-2011. However, the disproportionate distribution of SSP TB among different regions and subpopulations of the country highlights the need for more targeted interventions to accelerate the decline of TB in Zimbabwe.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. gnoppert@umich.edu.
authors.forename: Grace
authors.initials: G
authors.lastname: Noppert
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. zhenhua@umich.edu.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Yang
authors.affiliation: National TB Programme, AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe. dr.c.sandy@gmail.com.
authors.forename: Charles
authors.initials: C
authors.lastname: Sandy
authors.affiliation: Department of Community Medicine, College of Health Sciences, University of Zimbabwe, 3rd Floor New Health Sciences Building, Parirenyatwa Hospital Complex, Avondale, P O Box A178, Harare, Zimbabwe. joconiahc@gmail.com.
authors.forename: Joconiah
authors.initials: J
authors.lastname: Chirenda
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018563:Disease Notification / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011634:Public Health / Q000706:statistics & numerical data; D017678:Sex Distribution; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D015030:Zimbabwe / Q000453:epidemiology