Prevalence of Tuberculosis among Public Service Bus Station Users in Lusaka District, Zambia: A Pilot Project

Background: Public transport bus stations in Lusaka, Zambia’s capital city serve as a major transportation hub, connecting all provinces and international destinations. Given the high burden of tuberculosis (TB) in Zambia, this study aimed to estimate the prevalence of TB among public transport bus station users, including drivers, conductors, call boys, and commuters/traders. Methods: A descriptive quantitative study design was employed, screening 3967 participants from 5 public transport bus stations in Lusaka. Participants who met the TB screening criteria were considered presumptive cases and were subjected to further testing using GeneXpert MTB/RIF assay. Data analysis was performed using JASP statistical software to determine the prevalence of TB and identify associated factors. Results: Out of the 3967 participants screened, 670 TB presumptive cases were identified, and 26 cases were bacteriologically confirmed, yielding a positivity rate of 3.9%. This rate is significantly higher than the average estimated positivity rate. Notably, intercity routes had a higher burden of TB cases, including 2 cases of Rifampicin-Resistant TB, compared to local routes. Interestingly, the study found a higher proportion of TB cases among HIV-negative participants. Conclusion: This study reveals a significant prevalence of tuberculosis among public transport users in Lusaka, highlighting the need for targeted interventions to mitigate TB transmission in crowded public transportation settings, particularly in high-risk areas such as intercity routes. The findings underscore the importance of implementing TB control measures in public transport hubs to reduce the spread of the disease.