1. TB/ HIV CONTROL AND MANAGEMENT IN SOUTH AFRICA
Prelimanary Report on TB Data 2004 CF & 2003 TO
TB/ HIV CONTROL AND MANAGEMENT IN SOUTH AFRICA
Lindiwe Mvusi
Prepared by Carina Idema

2. Estimated Global TB Burden: 2009

3. Estimated incidence of new TB cases: 2009

4. Global MDR-TB Burden: 2009

5. HIV Prevalence among new TB cases: 2009

6. 10 Leading underlying natural causes of death
STATSSA, Mortality and causes of death in South Africa, 2008 Findings from death notification, 2010

7. Trends in TB Notifications: 2000 - 9

8. TB Case Notifications – 2008/9

9. Why is case detection low?
TB in children missed
Screening and diagnosis in HIV positive people low
Contact screening not conducted
Delays in diagnosis due to
Low index of suspicion by HCW
Lack of awareness by communities
Poor access to services – facilities/ labs

10. HIV PREVALENCE 2009, BY DISTRICT

11. Prelimanary Report on TB Data 2004 CF & 2003 TO
TB and HIV
Indicators
2005
2006
2007
2008
2009
TB patients tested
76988
110235
136247
150542
197448
TB patients HIV pos
35299
58249
87764
89950
114523
Co-infected started on CPT
57053
58801
64348
80954
Co-infected started on ART
11654
23344
20689
22107
48314
Total number HIV positive
458618
379672
668414
844617
HIV pos screened for TB
103056
150092
364261
433662
HIV pos diagnosed with TB
30026
15521
27391
54406
HIV pos started on IPT
2512
5642
15355
23583
Prepared by Carina Idema
Prepared by Carina Idema 11

12. Treatment outcomes, 2000-08 Year Cure rate (%) Treatment success (%)
Death rate (%)
Failure rate (%)
Defaulter rate (%)
Transfer rate (%)
Not evaluated (%)
2008
67.0 76
8.0
1.8
7.5
4.8
1.9
2007
62.5
71.7
7.4
8.2
5.1
5.9
2006
62.9
73.8
7.3
1.7
9.1
5.2
2.9
2005
57.6
70.8
10.4
5.5
4.3
2004
50.8
65.5
7.1
1.5
10.3
5.8
9.9
2003
50.9
1.2
11.2
7.0
10.2
2002
50.0
63.0
11.9
9.0
2001
49.7
60.5
6.7
11.1
12.7
2000
53.8
6.5
1.3
13.5 -

13. Reasons for the poor treatment outcomes
Poor support systems in communities
Access to health facilities
Health care worker attitudes
Substance/ alcohol abuse
Migration
Poor patient knowledge and understanding
Stigma – family, community, work, clinic
Poor referrals and follow up systems

14. Estimated burden of MDR-TB:2001
Worst case scenario
Best case scenario EC
2142
1169 FS
305
212 GP
1213
660
KZN
2616
1385 LP
832
455 MP
906
484 NC - NW
592
322 WC
770
422
Total
9329
4983

15. Prevalence of resistance among retreatment cases
MDR-TB (%)
Retreatment after cure
3.4
Retreatment after failure
25.5
Retreatment after default
7.4
Retreatment after completion
6.8
Unknown/ Other
7.2
Total
6.6

16. TB Drug Resistance, 2001 by province
NEW
RETREATMENT
MDR-TB
Any H
Any R
New
Retreatment EC
7.1
1.2
13.4
7.8
1.0
7.4 FS
6.4
2.4
6.9
2.9
1.8
1.7 GP
4.4
9.7
6.1
1.4
5.5
KZN
5.4
14.5
8.7
7.7 LP
12.5
10.2
6.8 MP
7.0
3.1
18.9
16.0
2.6
13.7 NC - NW
5.9
2.7
11.2
9.6
2.2 WC
5.2
0.9
6.6
3.9
Total
5.7
11.8
7.5
1.6

17. MDR-TB Notifications 2004-9
2005
2006
2007
2008
2009 EC
379
545
836
1092
1501
1858 FS
116
151
198
179
381
253 GP
537
676
732
986
1028
1307
KZN
583
1024
2200
2208
1573
1773 LP 59 40 77 91 85
204 MP
162
134
139
506
657
446 NC
168
155
188
199
290
631 NW
130
203
225
397
363
520 WC
1085
1192
1179
1771
2220
2078 SA
3219
4120
5774
7429
8198
9070

18. XDR-TB Notifications 2004-9
2005
2006
2007
2008
2009 EC 3 18 61
108
175
123 FS 1 6 4 GP 5 14 19 38 30 65
KZN 59
227
336
241
181
254 LP - 2 MP 12 NC 10 7 40 NW 9 13 WC 16 28 42 60 72 SA 85
298
464
458
488
594

19. Prelimanary Report on TB Data 2004 CF & 2003 TO
Conclusion
Good quality data, regular supervision and programme reviews as well as ongoing operational research are key to assessing programme performance and impact of interventions that are implemented.
Prepared by Carina Idema
Prepared by Carina Idema 19

20. Prelimanary Report on TB Data 2004 CF & 2003 TO
Thank you for listening
“STOP TB …….. BECAUSE YOU CAN”
Prepared by Carina Idema