Monitoring Urban Spatial Growth in Harare Metropolitan Province, Zimbabwe

Taking Harare metropolitan province in Zimbabwe as an example, we classified Landsat imagery (1984, 2002, 2008 and 2013) by using support vector machines (SVMs) and analyzed built-up and non-built-up changes. The overall classification accuracy for the four dates ranged from 89% to 95%, while the overall kappa varied from 86% to 93%. The results demonstrate that SVMs provide a cost-effective technique for mapping urban land use/cover by using mediumresolution satellite images such as Landsat. Based on land use/cover maps for 1984, 2002, 2008 and 2013, along with change analyses, built-up areas increased from 12.6% to 36.3% of the total land area, while non-built-up cover decreased from 87.3% to 63.4% between 1984 and 2013. The results revealed an urban growth process characterized by infill, extension and leapfrog developments. Given the dearth of spatial urban growth information in Harare metropolitan province, the land use/cover maps are valuable products that provide a synoptic view of built-up and non-built-up areas. Therefore, the land use/cover change maps could potentially assist decision-makers with up-to-date built-up and non-built-up information in order to guide strategic implementation of sustainable urban land use planning in Harare metropolitan province.

Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in Kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis

Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in Kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in Kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.

Climate Change and Variability in Southeast Zimbabwe: Scenarios and Societal Opportunities

A lot of researches have been done on the negative impacts and challenges caused by extreme weather conditions due to climate change and variability. Not many researches have been focused on the positive side in form of opportunities presented due to climate change. The study aimed to show the climate change scenarios and explore possible opportunities that could be derived from such scenarios in the southeastern region of Zimbabwe. The research used climate data records from three Zimbabwe Meteorological Services Department run weather stations in the region. The time series data were analyzed to show trends of rainfall and temperature over time. A questionnaire survey was also carried out to enquire from the farmers if they perceived climate change to have any opportunities. The rainfall trend analysis showed that rainfall amounts have declined at two of the three stations used. Rainfall total was also shown to be variable from year to year at all the stations. Ambient temperatures at all the stations were shown to have increased for both winter and summer. Opportunities that could be derived from climate change in the region were identified as the hydrological, agricultural and industrial. The research concludes that taking advantages of opportunities offered by climate change and variability provides the quickest way of embracing climate change adaptation.

Toxicity and Antiviral Activities of Some Medicinal Plants Used by Traditional Medical Practitioners in Zimbabwe

Genital herpes, usually caused by Herpes Simplex Virus type-2 (HSV-2), is the commonest sexually transmitted disease especially amongst rural women in Southern Africa including Zimbabwe. This predisposes them to HIV/AIDS infection, cancer and opportunistic infections (OIs). Current antiviral treatments are often cytotoxic and/or ineffective. This motivates active research to find alternative safer drugs or lead drugs from traditional medicinal sources. Twenty six (26) methanol extracts from commonly used and often endangered plant species (14) used by communities and traditional medical practitioners for treating illnesses and sexually transmitted diseases from 5-selected districts of Zimbabwe were investigated for toxicity by Brine shrimp lethality test (BSLT) and by 50% Cytopathic effect on VERO cultured cells. The extracts were also tested for antiviral activity against Herpes Simplex Virus-2 (HSV-2) by the End Point Titration Technique (EPTT) and Neutralisation Test (NT) on VERO cells. Results from the BSLTs ranged 66.66 - 4304 μg/ml;50% Cytopathic effect from 19.53 - 312 μg/ml whilst the NT ID50 values ranged from 10.41 - 125 μg/ml. The antiviral EPTT reduction factor (RF) was 1 - 104 with 13 extracts showing RF ≥ 103. All the plant extracts had moderate to high toxicity (LC50, 789 - 66 μg/ml) in the BSLT. Six extracts had LC50 values greater than 1000 μg/ml. All 26 extracts were cytotoxic with CC50 values < 500 ug/ml of which 19 were more toxic CC50 in vitro therapeutic indexes ≥ 3.7. Cassia abbreviata, Dichrostachys cinerea and Hypoxis hemerocallidea had therapeutic indexes (TI) 7.5 - 15.0. The more active plant extracts were from roots and root tubers. The results confirm the rationale for the use of traditional medicinal plants by traditional medical practitioners for treating various diseases and could bring awareness for their better use and improve conservation. The results also provide an opportunity to develop more efficacious drugs by isolating lead compounds and determining their mode of action.

Mineral Evaluations for Small Scale Miners:A Case for Zimbabwe and South Africa

Since the establishment of geological surveys in Southern Africa a lots of geological information has been systematically stored.Due to the vast amounts of data generated one of the main functions of

An Analysis of the Underlying Causes of Land and Environmental Degradation in Zimbabwe:Implications for Sustainable Evelopment

In recent years,the achievement of sustainable development has been the subject of international debate yet it remains a largely elusive goal for most developing countries.The broad objective of this study was to characterize land and environmental degradation in Zimbabwe’s communal areas.A semi-structured interview guide was used to

Hypertension in Zimbabwe: A meta-analysis to quantify its burden and policy implications

AIM: To estimate the pooled prevalence of hypertension in Zimbabwe and describe its trend since independence in 1980 using secondary source data.METHODS: MEDLINE, EMBASE and Scopus databases from April 1980 to December 2013 were searched for population and community based studies on the prevalence of hypertension among adults(≥ 18 years) in Zimbabwe. The key words used were "prevalence", "epidemiologic studies", "hypertension" or "high blood pressure", based on the cut-off(≥ 140 mm Hg systolic blood pressure and/or ≥ 90 mm Hg diastolic blood pressure). We conducted a meta-analysis on the published studies, using the random-effects model to estimate the pooled prevalence.RESULTS: The search retrieved 87 publications, of which four studies met the selection criteria. The four studies had a total of 4829 study participants between 1997 and 2010 across 5 provinces in Zimbabwe. Two studies were in urban areas, while the other two had mixed study settings(urban and rural). The overall pooled prevalence of hypertension was 30%(95%CI: 19%, 42%, I2= 98%, χ2 = 164.15, P = 0.00).CONCLUSION: Our results show a high prevalence of hypertension in Zimbabwe, with urban areas having higher prevalence than rural areas.

An Assessment of Trends of Monthly Contributions to Seasonal Rainfall in South-Eastern Zimbabwe

Trends in the proportional contribution to the seasonal rainfall of each month were analyzed for the meteorological stations of Buffalo Range, Masvingo Airport and Zaka in South-Eastern Zimbabwe. Results found indicate the existence of some trends for all the stations and months. However, when subjected to a Mann-Kendel trend analysis, all the trends were found to be statistically not significant for all instances except for the month of October at the Zaka station. This month showed a significant trend of increasing proportional rainfall.

Effective Use of Near Real-time Monitoring System for Stunting Reduction in Zimbabwe

Background:In Zimbabwe,26.2 percent of children under five are stunted.Evidence has shown that multi-sector interventions are key to addressing stunting.Yet,practical implementation is difficult,often occurring through separate disjointed and uncoordinated sector actions with limited access to real time information for decision-making.Objective:To describe the design,implementation,successes,challenges and lessons learned from using a near-real time monitoring(NRTM)system as a monitoring tool for multi-sectoral community based model for stunting reduction in Zimbabwe.Methods:An open source technology was used to obtain the information needed on the multi-sectoral coordination process,provide a common platform to capture and present data on situational factors,community conditions and practices to be acted upon and thus contribute to reducing stunting.Results:Significant improvements in community data flows were noted;the system brought together several types of data,concepts,stakeholders and multi-sector energies into focused programming.Several challenges including conceptual issues,initial coordination,financial resources and missed partnership opportunities were documented.The introduction of the NRTM system resulted in improved data flows for programme monitoring and facilitated multi-sector collaboration.Conclusion:NRTM is an effective monitoring tool for the multi-sectoral community based model to reduce stunting in Zimbabwe.

Prevalence and Factors Associated with Hypertension among Anti-Retroviral Therapy Patients Aged 15 Years and above in Makonde District, Zimbabwe, 2012: An Analytic Cross Sectional Study

Background: Anti-retroviral therapy (ART) has reduced morbidity and mortality among HIV-infected individuals over the last years. The increase in survival of HIV patients has contributed to the emergence of other chronic conditions in these individuals, such as hypertension, renal, and cardiovascular disease. Hypertension and HIV infection are both mostly asymptomatic but can lead to fatal and disabling illness. Hypertension among HIV-infected individuals, although not completely elucidated, may be explained by the aging of population, the effect of HIV on vascular tone anti-retroviral therapy and traditional risk factors such as weight gain, smoking, dyslipidemia, and drug abuse. The factors associated with hypertension among ART patients in a predominantly rural setting were studied in this paper. Methods: We conducted an analytical cross sectional study at 13 health facilities in Makonde District a rural district in Mashonaland West Province of Zimbabwe where we systematically selected 393 of 400 ART patients aged 15 years and above. Structured interviewer administered questionnaires were used to collect data on demographic characteristics. Written and informed consent was sought and obtained from all study participants. We obtained parental consent followed by assent from participants younger than 16 years. All enrolled patients had physical measurements done. Chi square test and stratified & logistic regression analysis were done using Epi info version 3.5.1. All calculations were done at 95% confidence interval. Results: Results from 393 participants were analysed. The prevalence and awareness of hypertension were 34.9% and 30% respectively. Only 9.6% were taking medication. Independent risk factors were duration of ART > 2 years (POR 2.23;95%CI: 1.08;4.61), waist to hip ratio (women) > 0.85 (POR 3.45;95%CI: 1.60;5.88), B.M.I > 25 (POR 2.18;95%CI: 1.40;3.8). Protective factors were: Symptomatic HIV disease (POR 0.36;95%CI: 0.14;0.97) and being informally employed (POR 0.67;95%CI: 0.43;0.96). General risk factors were smoking (POR 5.06;95%CI: 2.20;11.60), sedentary recreation (POR 3.16;95%CI: 1.69;5.85) and high salt intake (POR 2.67;95%CI: 1.56;4.59). Conclusions: Hypertension is common among ART clients although it is not routinely screened for in ART care settings in Makonde. Common modifiable risk factors are contributing to the burden of hypertension in Makonde District. Health service providers should routinely screen for hypertension and promote healthy lifestyles among ART clients in Makonde.

Evaluation of Notifiable Disease Surveillance System in Centenary District, Zimbabwe, 2016

Background: Notifiable disease surveillance system (NDSS) data guides immediate action for events of public health importance. In July 2016, 12 patients suspected of typhoid were reported to Centenary District Medical Officer by phone. Following reporting, notification forms (T1) were not submitted to district, hence province did not receive district consolidated report (T2) for the notifications. This implies underreporting of notifiable diseases. Study was conducted to evaluate NDSS in Centenary district. Methods: Using updated Centres for Disease Control and Prevention (CDC) guidelines, descriptive cross sectional study was conducted among health workers sampled from all health facilities in Centenary district. Interviewer administered questionnaire and checklists were used to collect data, assess data quality and resource availability. Epi InfoTM 7 generated frequencies and proportions. Results: We interviewed 50 respondents from 13 health facilities and 64% were females. Health worker knowledge was rated low, 26% knew whom to notify and 40% knew forms are completed in triplicate. Reasons for failure to notify notifiable diseases included, unavailability of reporting forms 32% and lack of reporting guidelines 16%. Ninety-two percent were willing to participate. Four health facilities had at least six standard case definitions. The first two patients were only diagnosed at district level. NDSS information was used to procure antirabies vaccine and implement control measures. Conclusion: NDSS is useful, acceptable, unstable and not sensitive. Failure to notify was mainly due to lack of knowledge on NDSS. We recommend training of health workers and mentoring. Fifteen (IEC) case definitions and reporting guidelines were distributed to five health facilities.

“Blessing or Curse”?Introduction of Bond Notes as an Antidote to Zimbabwe’s Liquidity Crises

The Zimbabwean financial sector has been retrogressive,constrained,and unpredictable since the year 2000,serving for the multiple currency periods(2009-2013)after the demonetization of the domestic dollar.The sector since then has seen a number of commercial banks fail to meet RBZ(Reserve Bank of Zimbabwe)minimum capital requirements,put under curatorship,delisted or liquidated because of a myriad of operational and financial challenges.The objective of this study is to make an assessment of whether or not the introduction of bond notes has been a curse or blessing.The study drew raw data from bank account holders,academics,general public,corporate world and commercial banks in Masvingo for analysis and interpretation.The study established that the majority of people,corporate world and commercial banks were sceptical to embrace the surrogate bond notes because of the uncertainties,operational and financial risks that they paused on the domestic financial markets.It was also discovered that most banks were quick to pay clients’withdrawals in bond notes,deduct US dollar equivalences from their accounts,and distinguish bond notes from US dollars at the point of making deposits and foreign business transactions.It was also realized that there was market indiscipline and trading in bigger US dollar notes in the informal sector and serious shortage of the same notes in the formal sector.The study concluded that the introduction of bond notes to trade parallel to the US dollar brought a serious shortage of cash on formal markets and increases in the general price level of goods and services.The study therefore recommends that the RBZ should completely withdraw the bond notes from the market to accord the US dollar its world market value and restore confidence and discipline in the Zimbabwean financial sector.The study also recommends another option of the adoption of the South African Rand as an interventionist way of solving Zimbabwe’s liquidity crises.

Evaluation of the Notifiable Diseases Surveillance System in Beitbridge District, Zimbabwe 2015

Back ground: Notifiable Disease Surveillance system serves as an early warning system for public health emergencies. Since January 2013 to August 2014, Beitbridge never submitted T2 forms to the province. Four suspected cases of rabies were reported through the generic report. The electronic District Health Information System 2, T2 forms had not been updated. This discrepancy may imply under reporting of Notifiable Diseases. The study was conducted to evaluate the NDSS in Beitbridge district. Methods: Descriptive cross-sectional study was conducted. Health workers in sampled health facilities were interviewed using questionnaires. Checklists were used to assess resource availability. Epi InfoTM was used to calculate frequencies and proportions. Results: From 11 facilities, 53 respondents were interviewed of which the 59% were females. For Knowledge, 57% recalled at least 9 Notifiable diseases, 11% knew the T1 form required to notify. Respondents willing to participate in the NDSS were 87%. Responsibility to notify was placed other health workers other than themselves by 55% of the respondents. All facilities did not have completed T1 forms. T1 forms were available in 1/11 health facilities. Three outbreaks were reported using the Weekly Disease Surveillance System (WDSS). NDSS information was used for planning and mobilizing resources for indoor residual spraying. It costs an average $12.15 to notify a single case, against $1.50 if it was electronic. Conclusion: NDSS is acceptable, simple, flexible, unstable, not sensitive and useful. Reasons for under reporting were lack of forms, lack of induction and poor knowledge on the NDSS. The cost of operating the NDSS could be reduced if the system is electronic. T1 forms and guidelines for completing the forms should be distributed to all health facilities. On the job training of health workers through tutorials, supervision is recommended.

Evaluation of Perinatal Mortality Surveillance System in the City of Bulawayo, Zimbabwe

Background: In Zimbabwe, the perinatal mortality surveillance system is based on passive reporting of perinatal deaths using the perinatal death notification forms. Mpilo hospital recorded 74 perinatal deaths from January to September. No death was reported to the city and no perinatal mortality forms were found at the health information section. We aimed to assess the performance of perinatal mortality surveillance system in Bulawayo city. Methods: We conducted a descriptive cross-sectional study in all the maternity centres in Bulawayo City in 2011 using Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. We used interviewer-administrated questionnaires to collect data. We used a checklist to assess availability of resources. Perinatal death notification forms were reviewed. Results: We interviewed 67 workers. Knowledge on the system was poor. Eight (12%) were trained in IDSR (Integrated Disease Surveillance Response) and three (4.5%) were inducted on the perinatal mortality surveillance system. Sixty-one (91%) regarded the system as useful. City and private maternity centres were not notifying perinatal deaths due to lack of forms. In central hospitals, delay in notification was due to workload and shortage of trained staff. Conclusion: Poor knowledge on the system, lack of induction and trained staff could have contributed to the non-performance of the system in the City of Bulawayo. Most participants reported the system as useful. Lack of documentation made it difficult to follow up on actions plans.

Evaluation of the Performance of Two Diagnostic Assays in Malaria Diagnosis in Mashonaland East Province, Zimbabwe, 2010

Introduction: Following the 2008 WHO in-vitro malaria RDT product testing study results, Paracheck RDT’s sensitivity was revealed to significantly drop to 55% at low parasite densities. This raised concerns among health workers on its diagnostic capabilities and possible public health implications resulting from its continued use? We therefore evaluated the diagnostic performance of Paracheck and SD Bioline (a yet to be evaluated kit) RDTs under operational settings in areas of different endemicity. Methods: Using an analytic cross-sectional study design, finger prick blood samples from 422 clinically diagnosed patients selected from Mudzi (high malaria burden) and Murewa (low malaria burden) districts were each tested for malaria using Paracheck and SD Bioline RDTs and Giemsa stain microscopy as gold standard. Parasitemias were calculated using WHO standard protocols. Main outcomes were test efficiency;sensitivity;specificity;PVP and NPV. Re-sults: Of eligible 390 blood slides prepared, microscopy detected malaria parasites in 125 (32.1%) with P. falciparum being predominant species (100%). Compared with microscopy, both Paracheck and SD Bioline RDTs performed fairly equally well and above WHO targets in Mudzi (high malaria burden), while in Murewa (low malaria burden) Paracheck and SD Bioline RDTs had sensitivities of 86.7% [69.5 - 100.0] and 86.7% [86.7 - 100.0];specificities of 97.2% [94.1 - 100.0] and 90.7% [85.3 - 96.2];test efficiencies of 95.9% [92.4 - 99.4] and 90.2% [85.0 - 95.5];PVPs of 73.3% and 45.2%;and NPVs of 98.8% and 98.7% respectively. Sensitivities for Paracheck and SD Bioline RDTs reduced from 99.2% [97.7 - 100.0] at parasitemias above 1000/μl each to 33.3% [0.0 - 71.1] and 50.0% [10.0 - 90.0] respectively at parasitemias below 1000/μl with variations not statistically significant. Conclusion: Paracheck RDT remains the MOHCC’s preferred diagnostic alternative in areas where good quality microscopy is not available in Zimbabwe. SD Bioline RDT provides another diagnostic alternative especially in areas of high malaria burden. However performance of both kits at parasitemias below 1000/μl needs further investigation.

Evaluation of the Tuberculosis Case Notification System, Mhondoro-Ngezi District, Zimbabwe, 2016

Background: Zimbabwe was 17th among 22 tuberculosis (TB) high burdened countries. In Zimbabwe, the TB case notification system tracks data on case detection and treatment. Mhondoro-Ngezi district was reporting less than half provincial case average of 251 cases per 100,000 population per year. Data were always two weeks late. We evaluated the surveillance system and determined reasons for low notification. Methods: A descriptive cross sectional study was conducted using the updated CDC guidelines. Structured questionnaires, notification registers and forms were used to collect data. Epi Info 7 was used to calculate means and frequencies. Results: All 17 facilities providing TB services were selected. Only two of these were diagnostic centres. Of the 41 health workers, 32 (78%) were nurses. All facilities were notifying and 38 (93%) of health workers had notified cases. Notification forms were available at all facilities and were transported to the district office by government vehicles once completed. Ten minutes on average were needed to complete a form and this was easy for 89% health workers. Data were being analysed at facilities by 83% of health workers and 71% took action after analysis. Feedback from district level was being received by 85% of health workers. The reasons for low notification included: few diagnostic centres, passive case detection and poor community involvement. Conclusions: The TB case notification system was acceptable, simple, representative and useful. Reasons for low notification included: few diagnostic centres, passive case detection and poor community involvement. As a result of this evaluation, a third diagnostic centre is being set up.

Can Zimbabwe be saved from the Brink of Collapse?

Zimbabwe,a country in the Southern Africa,is known as the“house of stones”which named the country with Shona language.In the past,Zimbabwe has been called as“the breadbasket of Africa”.However,Zimbabweans are living among no power,no water,and no money.What have caused for such situation and how can people save Zimbabwe from the brink of collapse?

Obesity: A Potential Pandemic for the 21st Century among the Youths in Zimbabwe

Background: Obesity is now reported as an epidemic in many developed countries, and it is an emerging public health concern in developing, transitional, and newly developed countries. The incidence of obesity increases during adolescence and persists into adulthood and becomes irreversible. In addition to biological causes like inheritance, cultural factors (such as dietary knowledge, attitudes and behaviours), socio-demographic factors may also play a central role in the etiology of obesity. The aim of the study was to describe young adults’ knowledge and perceptions about obesity, with a focus on comprehensibility and meaningfulness of obesity in their daily lives and its health implications. Methods: A cross-sectional descriptive design was used with 96 participants aged 18 - 35 years. The respondents’ body mass indices (BMI) were calculated from self-reported weights and heights. Descriptive analytical, statistical methods were used for data analysis. Results: The youths had good knowledge about obesity, its causes and associated complications. Generally, negative attitudes toward obesity were reported. Some perceived obesity as the ideal body image among today’s youths while others perceived obesity as something that was beyond their control. Identified knowledge gaps were in the area of obesity and nutrition knowledge, food preferences and implications to health. Knowledge deficit about obesity might lead to poor health-related behaviours with its associated complications. Conclusion: There is a need to intensify community-focused health education as a preventive strategy to empower the youths to take charge of their health and change their perceptions about obesity.

Evaluation of the HIV Case-Based Surveillance System: A Pilot of the Electronic Health Record System in Mutare District, Zimbabwe, 2021

Background: Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. Methods: We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. Results: The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). Conclusion: The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.

Secondary Data Analysis of Tuberculosis Deaths in Bulawayo Province, Zimbabwe, 2016-2019

Background: Tuberculosis is a leading cause of death globally, and the third leading cause of death in Zimbabwe. Death from any cause following a diag-nosis of tuberculosis is classified as a tuberculosis death. Bulawayo Province reported high tuberculosis death rates from 15.3% in 2016 to 14.2% in 2019 against a threshold of 5%. We analyzed tuberculosis deaths for Bulawayo Province to characterize patients dying and to make recommendations for im-proving treatment outcomes for susceptible tuberculosis cases. Methods: A descriptive cross-sectional study was conducted. We analyzed all (N = 469) records of tuberculosis deaths from 19/19 Bulawayo tuberculosis diagnosing centers from 01 January 2016 to 31 December 2019. Microsoft® Excel 2007 was used to generate graphs and Stata® version 17 was used to conduct chi-square tests for trends. Results: Males accounted for 278/469 (59.3%) of the deaths. The median age of death was 40 years (Q1 = 33: Q3 = 51). The proportion of TB deaths increased from 63/114 (55%) in 2016 to 57/90 (63%) in 2019 for males (p Conclusion: High death rates particularly in the intensive phase, could be attributed to sub-optimal clinical care. Tuberculosis programs should work towards adopting differentiated care models for tuberculosis patients and developing algorithms for patients at high risk of death.