TB Control in South Africa

2017 ◽  
pp. 27-33
Author(s):  
Halima Dawood ◽  
Nesri Padayatchi
Keyword(s):  
South Africa ◽  
Tb Control

scholarly journals Comparing the Application of CEA and BCA to Tuberculosis Control Interventions in South Africa

2019 ◽  
Vol 10 (S1) ◽  
pp. 132-153 ◽  
Author(s):  
Thomas Wilkinson ◽  
Fiammetta Bozzani ◽  
Anna Vassall ◽  
Michelle Remme ◽  
Edina Sinanovic
Keyword(s):  
South Africa ◽  
South African ◽  
Methodological Approach ◽  
Value Of Statistical Life ◽  
Policy Recommendations ◽  
Benefit Cost Analysis ◽  
Tb Control ◽  
Statistical Life ◽  
Benefit Cost ◽  
The Impact

Achieving ambitious targets to address the global tuberculosis (TB) epidemic requires consideration of the impact of competing interventions for improved identification of patients with TB. Cost-effectiveness analysis (CEA) and benefit-cost analysis (BCA) are two approaches to economic evaluation that assess the costs and effects of competing alternatives. However, the differing theoretical basis and methodological approach to CEA and BCA is likely to result in alternative analytical outputs and potentially different policy interpretations. A BCA was conducted by converting an existing CEA on various combinations of TB control interventions in South Africa using a benefits transfer approach to estimate the value of statistical life (VSL) and value of statistical life year (VSLY). All combinations of interventions reduced untreated active disease compared to current TB control, reducing deaths by between 5,000 and 75,000 and resulting in net benefits of Int$3.2–Int$137 billion (ZAR18.1 billion to ZAR764 billion) over a 20-year period. This analysis contributes to development and application of BCA methods for health interventions and demonstrates that further investment in TB control in South Africa is expected to yield significant benefits. Further work is required to guide the appropriate analytical approach, interpretation and policy recommendations in the South African policy perspective and context.

scholarly journals Combined antiretroviral and antituberculosis drug resistance following incarceration

2013 ◽  
Vol 14 (3) ◽  
pp. 135-137 ◽  
Author(s):  
Katharine Elizabeth Stott ◽  
Tulio De Oliveira ◽  
Richard John Lessells
Keyword(s):  
Public Health ◽  
South Africa ◽  
Drug Resistance ◽  
Health Systems ◽  
Control Strategies ◽  
Antituberculosis Drug ◽  
Tb Control ◽  
Prison Health ◽  
Kwazulu Natal

We describe a case of HIV/tuberculosis (TB) co-infection from KwaZulu-Natal, South Africa, characterised by drug resistance in both pathogens. The development of drug resistance was linked temporally to two periods of incarceration. This highlights the urgent need for improved integration of HIV/TB control strategies within prison health systems and within the broader public health framework.

scholarly journals TB Control in Humans and Animals in South Africa: A Perspective on Problems and Successes

2018 ◽  
Vol 5 ◽  
Author(s):  
Christina Meiring ◽  
Paul D. van Helden ◽  
Wynand J. Goosen
Keyword(s):  
South Africa ◽  
Tb Control

scholarly journals South Africa and national TB control: Are we making progress?

2017 ◽  
Vol 59 (2) ◽  
pp. 4
Author(s):  
Gboyega A Ogunbanjo
Keyword(s):  
South Africa ◽  
World Health Organisation ◽  
Incidence Rates ◽  
World Health ◽  
Hiv Positive ◽  
Western Cape ◽  
Eastern Cape ◽  
Tb Control ◽  
Kwazulu Natal ◽  
The World

South Africa accounts for the worst global tuberculosis epidemics fuelled by the spread of HIV infection. The tuberculosis (TB) incidence increased from 300 per 100,000 people in the early 1990s to more than 950 per 100,000 in 2012.1 In addition, the country remains one of the countries with the highest TB burden globally, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.2 This means that about 0.8% of South Africa’s population of 54 million develop active TB disease annually. Of the 454 000 TB cases in South Africa in 2015, WHO estimated that about 57% (258,000) were HIV positive. It also estimated that of 157,505 whose status was known, and who were known to be HIV positive, some 85% (133,116) were on antiretroviral therapy.3 From the same 2015 report, Eastern Cape, KwaZulu-Natal and Western Cape provinces had the highest incidence rates of 692, 685 and 681 per 100,000 respectively. The most notable decline was in KwaZulu-Natal where the incidence decreased from 1,185 to 685 per 100,000 over the last five years.1

scholarly journals The treatment outcomes of tuberculosis among health care workers in a general hospital in the Mpumalanga province, South Africa

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Idongesit S. Ukpe ◽  
Julia Blitz ◽  
Jannie Hugo ◽  
Ralph Nkosi ◽  
Thembi Mpangane ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Treatment Outcomes ◽  
Health Care Workers ◽  
Clinical Care ◽  
Pulmonary Tb ◽  
Mpumalanga Province ◽  
Tb Control ◽  
Care Services ◽  
Care Workers

Background: South Africa is one of the countries in the world with a high burden of tuberculosis (TB). High rates of unfavourable treatment outcomes have remained a feature of TB control in the country. The objective of the current study was to examine the treatment outcomes of TB among health care workers (HCWs) at a rural general hospital in the Mpumalanga province of the country, as well as the clinical care that was provided to the HCWs. The purpose of the study was to identify possible areas for improvement in the TB care services provided to HCWs in the hospital, especially with regard to their clinical management.Method: The research described in this article consists of a retrospective descriptive study. Relevant data on HCWs diagnosed with TB in the hospital during 2007, the TB care services offered to the HCWs, and the treatment outcomes of the HCWs were captured from the occupational health and TB control programme registers at the hospital onto a data capture sheet for the study and were subsequently analysed manually.Results: Nine HCWs, eight females and one male, were diagnosed and treated for TB in the hospital during 2007, an incidence rate of 941/100 000. Their ages ranged from 39 to 54 years, with a mean age of 48 years. By occupation, the nine HCWs consisted of six nurses (67%), one porter (11%), one general assistant (11%), and one clerk (11%). Of those treated for TB, seven (78%) had smearpositive pulmonary TB (PTB) and two (22%) had extra-pulmonary TB (EPTB). TB culture and drug susceptibility testing (DST) was undertaken for only one HCW. The HIV status was known for only two (22%) of the nine HCWs under review. Neither of the two HCWs with EPTB had the diagnosis confirmed by bacteriological or histopathological method. The seven HCWs with smear- positive PTB achieved a cure, and the two HCWs with EPTB successfully completed treatment, resulting in a treatment success rate of 100% for the nine HCWs.Conclusion: The HCWs at Themba Hospital in the Mpumalanga province of South Africa who were diagnosed and treated for TB during 2007 all achieved favourable treatment outcomes. However, in view of the high rate of HIV/TB co-infection and the increasing problem of drug-resistant TB in the country, the clinical care provided to HCWs with TB by the hospital should be improved with regard to routine HIV counselling and testing and the routine early provision of DST. A protocol for the comprehensive management of HCWs with TB is currently undergoing development.

scholarly journals Tuberculosis: treatment failure, or failure to treat? Lessons from India and South Africa

2019 ◽  
Vol 4 (1) ◽  
pp. e001097 ◽  
Author(s):  
Nesri Padayatchi ◽  
Amrita Daftary ◽  
Naressa Naidu ◽  
Kogieleum Naidoo ◽  
Madhukar Pai
Keyword(s):  
South Africa ◽  
Health Concern ◽  
Control Analysis ◽  
Public Health Concern ◽  
Tb Control ◽  
Cascade Of Care ◽  
Incident Cases ◽  
Compare And Contrast

Tuberculosis (TB) remains an enormous public health concern globally. India and South Africa rank among the top 10 high TB burden countries with the highest absolute burden of TB, and the second highest rate of TB incidence, respectively. Although the primary drivers of TB transmission vary considerably between these two countries, they do indeed share common themes. In 2017, only 64% of the global estimated incident cases of TB were reported, the remaining 36% of ‘missing’ cases were either undiagnosed, untreated or unreported. These ‘missing TB cases’ have generated much hype for the challenges they present in achieving the End TB Strategy. Although India and South Africa have indeed made significant strides in TB control, analysis of the patient cascade of care clearly suggests that these ‘missed’ patients are not really missing—most are actively engaging the health system—the system, however, is failing to appropriately manage them. In short, quality of TB care is suboptimal and must urgently be addressed, merely focusing on coverage of TB services is no longer sufficient. While the world awaits revolutionary vaccines, drugs and diagnostics, programmatic data indicate that much can be done to accelerate the decline of TB. In this perspective, we compare and contrast these two national epidemics, and explore barriers, with a particular focus on the role of health systems in finding the missing millions.

Tuberculosis and Social Stratification in South Africa

1990 ◽  
Vol 20 (1) ◽  
pp. 141-165 ◽  
Author(s):  
Neil Andersson
Keyword(s):  
South Africa ◽  
Health Care ◽  
Social Stratification ◽  
Access To Health Care ◽  
Racial Classification ◽  
Tb Control ◽  
The Past ◽  
Access To Health ◽  
Gold Miners ◽  
The Republic

Tuberculosis (TB) continues to be a barometer of poverty, determined by racial classification, in both town and countryside in the Republic of South Africa. Despite the fact that whites with the disease stand a greater chance of being diagnosed than their black counterparts, because they have very much better access to health care, the risks of TB for people classified by the state as black and colored are 27 and 16 times, respectively, the risk for whites. Black gold miners, the nutritional elite of the workforce, have also experienced an increase in TB rates. Tuberculosis accounts for 50 percent of all black compensation cases and some 2.5 percent of white cases. The risks of TB have increased over recent years among coloreds and blacks. Rates of tuberculous meningitis have also increased over the past decade, and show the dramatically worse health care available to people classified as black and colored. Although about 60,000 new TB cases are reported in the country each year, there have been cutbacks in the resources available for TB control and treatment.

scholarly journals High level of initial default among smear positive pulmonary tuberculosis in eThekwini health district, KwaZulu-Natal

2016 ◽  
Vol 31 (2) ◽  
pp. 41-43
Author(s):  
Lindiwe P. Cele ◽  
Stephen Knight ◽  
Elize Webb ◽  
Khin Tint ◽  
Thembelihle Dlungwane
Keyword(s):  
Infectious Disease ◽  
South Africa ◽  
Pulmonary Tuberculosis ◽  
Case Identification ◽  
Tb Control ◽  
Kwazulu Natal ◽  
High Incidence ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Control Programmes ◽  
High Level

In this study, initial tuberculosis (TB) default was measured in clinics in a district with a high incidence of TB. A retrospective review of TB case identification registers in 2007 found 4049 (9.0%) new smear positive pulmonary tuberculosis (PTB) cases from 44 987 suspects. There were 725 (17.9%) initial defaulters. Fifty-three percent of those traced had already died. TB is the leading cause of death in South Africa due to an infectious disease, and the high level of initial defaults in PTB is one of the “unresolved issues” in TB control programmes that needs to be addressed.

Time and Latitude in South Africa

1972 ◽  
Vol 1 ◽  
pp. 27-38
Author(s):  
J. Hers
Keyword(s):  
South Africa ◽  
Cape Town ◽  
Astronomical Observations ◽  
Royal Observatory ◽  
The Republic ◽  
Astronomical Determination ◽  
Limited Accuracy ◽  
Better Than

In South Africa the modern outlook towards time may be said to have started in 1948. Both the two major observatories, The Royal Observatory in Cape Town and the Union Observatory (now known as the Republic Observatory) in Johannesburg had, of course, been involved in the astronomical determination of time almost from their inception, and the Johannesburg Observatory has been responsible for the official time of South Africa since 1908. However the pendulum clocks then in use could not be relied on to provide an accuracy better than about 1/10 second, which was of the same order as that of the astronomical observations. It is doubtful if much use was made of even this limited accuracy outside the two observatories, and although there may – occasionally have been a demand for more accurate time, it was certainly not voiced.

Indirect Rule in South Africa

2009 ◽  
Author(s):  
J. C. Myers
Keyword(s):  
South Africa ◽  
Indirect Rule
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