Evaluation of Factors Contributing to Low TB Detection Rate in Selected Facilities of Ndola District

Abstract : Tuberculosis (TB) remains a major global public health challenge, particularly in low- and middle-income countries where case detection rates remain below international targets. In Zambia, the TB detection rate remains significantly lower than the 75% target recommended by the World Health Organization (WHO), posing a threat to effective TB control. This study evaluated the factors contributing to low TB detection rates in selected health facilities in Ndola District, Copperbelt Province of Zambia. A quantitative cross-sectional study design was employed. Data were collected from 93 respondents comprising health care workers and community members selected from 33 health facilities providing TB services. Structured questionnaires and face-to-face interviews were used to gather information on demographic characteristics, knowledge of TB symptoms, availability of diagnostic services, and barriers to TB detection. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics such as frequencies and percentages were used to summarise the data. The findings revealed that inadequate laboratory equipment was the most frequently reported factor contributing to low TB detection (55.9%), followed by limited community awareness of TB disease (24.7%). Other factors identified included TB-related stigma (7.5%), shortage of skilled laboratory personnel (6.5%), and long distances to health facilities (5.4%). The study further established that cough was the most widely recognised TB symptom among respondents, while awareness of other symptoms such as fever and night sweats was relatively low. The study concludes that low TB detection in Ndola District is influenced by both health system constraints and community-related factors. Strengthening diagnostic capacity, increasing public awareness of TB symptoms, addressing stigma, and improving access to diagnostic services are critical interventions for improving TB case detection. Enhancing these strategies will contribute to early diagnosis, improved treatment outcomes, and reduced transmission of tuberculosis within the community.