25/02/2026
Kumasamilia Ana Atontho: Caring for the Young Ones Through the ZAMSA TB Study
Kumasamilia ana atontho, meaning “caring for the young ones,” captures the core purpose of the ZAMSA TB study, locally known as the Atontho study. The study focuses on protecting young children from tuberculosis (TB) by improving how TB transmission is understood and addressed in high-burden settings.
Pictured is the ZAMSA team conducting community recruitment and sensitisation activities in Lusaka’s Chipata Compound, one of the study sites. The study is also being implemented in Kanyama, where it aims to recruit approximately 2,400 children combined.
The overall aim of the ZAMSA TB study is to develop and validate innovative epidemiological methods for understanding recent TB transmission. This is achieved through convenience serosampling, which measures immune responses to Mycobacterium tuberculosis (Mtb). The findings will support the targeted deployment of TB prevention interventions such as TB vaccines and help measure their impact during implementation.
Funded by the Wellcome Trust, the study is conducted by Zambart in collaboration with the University of Glasgow, the University of Cape Town, and the Malawi Liverpool Wellcome Project. It aims to recruit children aged 1 to 5 and will be implemented for 4 years.
In Lusaka, the study applies a mixed-methods approach comprising three key components: a cross-sectional study, a nested cohort study, and a qualitative study. The cross-sectional component uses convenience sampling-based IGRA testing among young children attending health facilities for non-illness-related reasons. This is complemented by geospatial mapping using the Electronic Participant Locator (ePaL). In parallel, random community-based sampling is being undertaken to validate the convenience sampling approach. To-date, over 780 children have been recruited, and the study estimates that cross-sectional components will be concluded this year.
By generating new ways to monitor TB transmission, the ZAMSA TB study aims to strengthen TB surveillance, support the identification of transmission hotspots, and inform targeted public health interventions. The surveillance methodology may also be useful for measuring the impact of population-wide interventions like the rollout of novel TB vaccines, which will soon be available. It may also be applied to other infectious diseases.
Importantly, by testing young children for TB infection and assessing them for TB disease, the study facilitates early detection and linkage to care, contributing to improved paediatric TB prevention and control efforts. Through this work, Zambart continues to advance evidence-based solutions that protect the health and well-being of children and communities, thereby Improving_Health_for_All.
Ministry of Health Zambia Wellcome Trust Trust