<p>We analysed data from 10 ILI/SARI surveillance sites in Zambia from January 2021 to December 2022. ILI was defined as fever ≥38.0°C and cough of ≤10 days duration; SARI was defined as ILI (measured or reported fever) that required hospitalization. COVID-19 waves were defined according to national case surveillance data (which used all SARS-CoV-2 tests done in Zambia to define waves). We calculated the percentage of SARS-CoV-2 positive specimens among patients. Logistic regression was used to measure the odds of testing SARS-CoV2 positive during wave periods and by demographic characteristics.</p>