Setting: Zimbabwe has a human immunodeficiency virus
(HIV) driven tuberculosis (TB) epidemic, with antiretroviral
therapy (ART) scaled up in the public sector since
2004.
Objective: To determine whether national ART scale-up
was associated with annual national TB case notification
rates (CNR), stratified by disease type and category, between
2000 and 2013.
Design: This was a retrospective study using aggregate
data from global reports.
Results: The number of people living with HIV and retained
on ART from 2004 to 2013 increased from 8400
to 665299, with ART coverage increasing from 0.5% to
48%. TB CNRs, all types and categories, increased from
2000 to 2003, and declined thereafter from 2004 to
2013. The decreases in annual TB notifications between
the highest rates (before 2004) and lowest rates (2013)
were all forms of TB (56%), new TB (60%), previously
treated TB (53%), new smear-positive pulmonary TB
(PTB) (40%), new smear-negative/smear-unknown PTB
(58%) and extra-pulmonary TB (58%).
Conclusion: Significant declines in TB CNRs were observed
during ART scale-up, especially for smear-negative
PTB and extra-pulmonary TB. These encouraging national
trends support the continued scale-up of ART for
people living with HIV as a way of tackling the twin epidemics
of HIV/acquired immune-deficiency syndrome
and TB in Zimbabwe.