<p>TPT surge data.</p>

We collected and analyzed aggregate data from facility registers. A total of 19,371 HIV-negative contacts aged ≥ 5 years were screened: 99.9% (n = 19,344) were eligible for and offered TPT. Of these, 72.4% (n = 14,000) were initiated on TPT, 2.0% (n = 385) refused and 26.2% (n = 4,959) were not initiated on treatment due to unavailability of their preferred regimen.

The start of the surge was associated with an immediate 47.7% points increase in TPT coverage (p = 0.001). Overall, 63.7% (n = 8,917) were initiated on three-months Isoniazid+Rifapentine, followed by six-months Isoniazid (30.2%, n = 4226); one-month Isoniazid+Rifapentine (4.5%, n = 625) and on three-months Isoniazid+Rifampicin (1.7%, n = 232). The surge demonstrated that TPT can be rolled out to ≥5 years old HIV-negative TB contacts with high initiation rates achieved.

This is achievable through targeted implementation, stakeholder engagement, and community-driven approaches. These findings underscore the feasibility of extending TPT to all TB contacts, regardless of HIV status or age, to accelerate TB prevention efforts in high-burden settings like Zambia.</p></div>