Tuberculosis is a major public health problem in Tanzania. The burden of
tuberculosis in the country is monitored through a routine notification system.
Although the routine tuberculosis surveillance data have been consistent over the
years, there are still areas of uncertainty, which make the data not easily translated
into exact estimation of tuberculosis disease burden. The lack of information on the
true burden of tuberculosis disease in Tanzania stimulated a decision to conduct a
national tuberculosis prevalence survey to provide the context in which other
available data such as tuberculosis notification and mortality can be re-assessed. The
prevalence survey also provided us with a unique opportunity to look at other factors
which are important in tuberculosis control at the community level. The survey
provided us with an opportunity to have add-on studies to study the health careseeking
behaviour of individuals with symptoms of tuberculosis and to assess factors
associated with tuberculosis at a community level in a national scale.
Our prevalence survey conducted in 2012 showed that the weighted prevalence for
sputum smear-positive was 249 per 100000 adult population and for
bacteriologically-confirmed tuberculosis cases it was 293 per 100000 adult
population. The bacteriologically-confirmed tuberculosis prevalence was markedly
higher in mainland Tanzania (298/100000 adult population) than in Zanzibar
(124/100000 adult population). The prevalence was twice as high in men as in
women. The highest prevalence was found in the oldest age group of 65 years and
older. In addition, low socioeconomic position was associated with higher
tuberculosis prevalence. Individuals 45 years or older constituted 55% (71/129) of the
identified smear positive cases, but just 28% (6793/24648) of the notified
tuberculosis cases. Chest X-ray (CXR) screening identified more tuberculosis cases
than symptoms screening. Weighted for the prevalence of HIV in the notified new
smear-positive cases, the overall case detection of incident tuberculosis cases in 2012
was between 37% and 48%.