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Landmark tb survey


It is important that everyone with TB is diagnosed timeously, started on treatment and remains in the system until cured

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A SURVEY to address the incidence of tuberculosis (TB), the first one in South Africa, will be held in the Northern Cape later this year.

The survey, which will take place throughout the country, has been commissioned by the national Department of Health and aims to determine the bacteriological or laboratory confirmed prevalence of TB in South Africa by enrolling an estimated 55 000 participants.

Data collection will be systematically done in 110 clusters across all nine provinces, including the Northern Cape.

The survey commenced in KwaZulu-Natal in August 2017 and is scheduled to conclude in Gauteng in November 2018.

The proposed date for the Northern Cape is in August this year.

It is expected that results will be announced in 2019.

“The TB prevalence survey that covers the whole country is long overdue. The survey will not only provide an estimate of South Africa’s true TB burden, but it will also provide invaluable information to strengthen South Africa’s response needed to stop and end TB in our life time,” Dr Yogan Pillay, Deputy Director-General: HIV/Aids, TB, MCWH at the national Department of Health, said recently.

The survey, which is expected to yield results to extrapolate the challenges with TB control, the level of awareness amongst the public about TB and reflect evidence on how and where people seek care, will be conducted by the South African Medical Research Council (SAMRC), the Human Sciences Research Council (HSRC) and the National Institute for Communicable Diseases (NICD).

TB is the leading cause of death in South Africa and 2014 data revealed that 8.4% of deaths nationally were attributed to the disease.

2015 data estimated that 454 000 people developed TB, while 300 000 were treated for the disease and of those patients only 252 000 were successfully treated and an estimated 19 500 patients lost to follow-up.

“The survey is using the latest technology that is highly sensitive and specific for diagnosing TB. This is an exciting time and we encourage all fellow South Africans to be part of this momentous activity,” Dr Nazir Ismail, Head of the Centre for Tuberculosis at the National Institute for Communicable Diseases, said.

People are not fully aware of the signs and symptoms of TB, and as a result the disease is diagnosed at an advanced stage when medical intervention is sought. These patients are at risk of death. About a third of patients who are diagnosed with TB, do not start with treatment, and are regarded as “missing” cases.

“The survey will also provide information on how people who might have TB seek care in South Africa. It follows scientifically valid methodologies that have been used globally. The survey targets everyone who is 15 years and older in the selected areas. We encourage all people who are invited to participate fully by completing all the survey procedures,” HSRC Principal Investigator Dr Sizulu Moyo pointed out.

It is important that everyone with TB is diagnosed timeously, started on treatment and remains in the system until cured.

Most forms of TB can be rapidly diagnosed and treatment started within days.

People with TB who are not on treatment are infectious and continue to transmit the disease to those in close contact with them, and are the silent drivers of the epidemic.

“The findings of this survey will be a landmark event in the epidemiology of TB in South Africa. The results will influence response strategies, programmes and interventions to build on the existing successes in response to managing the TB epidemic,” Professor Martie van der Walt, Co-Principal Investigator of the survey, added.

The HSRC fieldworkers, clearly identifiable through survey attire and identification logos, will randomly visit selected households to invite eligible community members to participate in the survey.

Participation is voluntary and the information and confidentiality of each participant is carefully protected.

Participants will be asked questions about the typical signs and symptoms of TB, being persistent coughing, having night sweats, fever, weight loss and tiredness.

A chest X-ray will be taken.

If there is any suspicion of tuberculosis or if there are any abnormalities on the chest X-ray, the participant will be requested to produce a sputum specimen, which will be investigated for the presence of Mycobacterium tuberculosis, the bacterium which causes TB.

If there are any TB organisms in the sputum, the result will be provided to the focal TB person of the cluster, which will contact the participant in order to link him or her to care and treatment.