By Kuda Pembere
Zimbabwe’s efforts to curb tuberculosis (TB) infections have shown gradual progress, but significant challenges remain ahead of its 2026 target. The country had set an ambitious goal of reducing new TB infections to 48 per 100,000 people by 2026. As of 2024, however, TB incidence stood at 211 per 100,000, a notable improvement from 240 per 100,000 recorded the previous year.
Speaking at a Zimbabwe College of Public Health Physicians (ZCPHP) TB meeting last Saturday, Dr. Rutendo Manyati, representing Dr. Fungai Kavenga, Deputy Director of the AIDS and TB Department in the Ministry of Health and Child Care, acknowledged the steady gains.
Delving deeper into Zimbabwe’s TB burden, we know we have big goals as a country. However, as of 2024, our incidence stood at 211 per 100,000. This is an improvement, and we are consistently making progress,” said Dr. Manyati.
Despite these gains, the country’s TB control efforts were severely impacted by the COVID-19 pandemic.
“There was a setback during the pandemic when TB care services were marginalized within essential healthcare services so that we could focus on battling COVID-19. This partially reversed the gains made in TB control,” explained Dr. Kavenga.
He also highlighted gender disparities in TB infections, a pattern consistent with global trends.
“About 60% of our TB clients are male, compared to females. This follows the global pattern, where around 55% of all TB patients are male,” Dr Kavenga said.
Dr Kavenga said Zimbabwe’s TB/HIV co-infection rate currently stands at 51%, a slight improvement compared to previous years. The TB-related death rate remains at 7%.
“We are performing better regarding HIV co-infection among TB patients. In 2022, out of approximately 15,000 TB notifications, 7% of patients either died or failed to be cured,” noted Dr. Kavenga.
Treatment coverage remains a key concern, fluctuating between 50% and 60% from 2020 to 2024.
“We continue to miss cases. Factors contributing include overestimations of expected cases, insufficient outreach of strategies, resource constraints, limited knowledge among healthcare workers, and persistent stigma,” Dr. Kavenga explained.
Zimbabwe has also struggled with managing drug-resistant TB (DR-TB), identifying only about 30% of the expected cases between 2020 and 2024.
“We had initiated a drug-resistant TB survey funded by the US Government, but unfortunately, we have not been able to continue with it. The survey was intended to help us better estimate the number of DR-TB cases. Hopefully, through routine surveillance, we will improve our estimates and performance,” he said.
Dr. Kavenga highlighted significant geographical disparities in TB notification rates.
“Notification rates for both drug-sensitive and drug-resistant TB are notably higher in the southern provinces, particularly Matabeleland North, Midlands, Bulawayo, and Matabeleland South, compared to northeastern regions,” he said.
He attributed the disparities partly to proximity to neighboring countries with high TB rates and higher levels of infectivity.
“For drug-resistant TB, Matabeleland South, Masvingo, Midlands, and Bulawayo are the hardest hit,” he added.
In a related development, Dr. Mukwekwereke from the University of Zimbabwe Clinical Research Centre shared insights into ongoing research aimed at shortening TB treatment and prevention regimens.
“Currently, we are participating in a study called the ImagineTBM study. It is a TB meningitis study enrolling participants with or without HIV. Our goal is to try and shorten TB meningitis treatment from 36 weeks to 24 weeks,” she said.
The ImagineTBM study is a randomized, open-label, multi-center Phase 2 trial enrolling participants aged 15 and older who have probable, definite, or possible TB meningitis. Each study arm will enroll 150 participants.
“In the experimental arm (Arm A), we are using high-dose rifampicin, high-dose isoniazid, and linezolid. The control arm receives the standard TB treatment regimen,” Dr. Mukwekwerere explained.
She added that results from another TB treatment-shortening study, also involving the Centre, are pending publication.
