Abstract
BackgroundIn South Africa the estimated incidence of all forms of tuberculosis (TB) for 2008 was 960/100000. It was reported that all South Africans lived in districts with Directly Observed Therapy, Short-course. However, the 2011 WHO report indicated South Africa as the only country in the world where the TB incidence is still rising.AimsTo report the results of a TB prevalence survey and to determine the speed of TB case detection in the study communities.MethodsIn 2005 a TB prevalence survey was done to inform the sample size calculation for the ZAMSTAR (Zambia South Africa TB and AIDS Reduction) trial. It was a cluster survey with clustering by enumeration area; all households were visited within enumeration areas and informed consent obtained from eligible adults. A questionnaire was completed and a sputum sample collected from each adult. Samples were inoculated on both liquid mycobacterium growth indicator tube (MGIT) and Löwenstein-Jensen media. A follow-up HIV prevalence survey was done in 2007.ResultsIn Community A, the adjusted prevalence of culture positive TB was 32/1000 (95%CI 25–41/1000) and of smear positive TB 8/1000 (95%CI 5–13/1000). In Community B, the adjusted prevalence of culture positive TB was 24/1000 (95%CI 17–32/1000) and of smear positive TB 9/1000 (95%CI 6–15/1000). In Community A the patient diagnostic rate was 0.38/person-year while in community B it was 0.30/person-year. In both communities the adjusted HIV prevalence was 25% (19–30%).DiscussionIn both communities a higher TB prevalence than national estimates and a low patient diagnostic rate was calculated, suggesting that cases are not detected at a sufficient rate to interrupt transmission. These findings may contribute to the rising TB incidence in South Africa. The TB epidemic should therefore be addressed rapidly and effectively, especially in the presence of the concurrently high HIV prevalence.
Highlights
South Africa has high TB and HIV prevalence rates and has not reported a country-wide TB prevalence survey since 1998 [1]
In 36 enumeration areas, 7667 adults were enumerated in the two study communities (Figure 1). 6296 adults consented to participate and provided a sputum sample, of whom 5670 adults had culture results and 242 had a positive culture
This paper reports a very high prevalence of culture positive pulmonary TB in the communities studied
Summary
South Africa has high TB and HIV prevalence rates and has not reported a country-wide TB prevalence survey since 1998 [1]. In. South Africa the estimated incidence of all forms of TB for 2008 was 960/100000 with an annualised increase in estimated incidence from 1998–2008 of 6.4% [2]. In 2007 it was reported that the total South African population lived in districts with doi:10.1371/journal.pone.0058689.g001. Barcodes were used on questionnaires, sample containers and results and linked data of individuals without using names. In South Africa the estimated incidence of all forms of tuberculosis (TB) for 2008 was 960/100000. It was reported that all South Africans lived in districts with Directly Observed Therapy, Short-course. The 2011 WHO report indicated South Africa as the only country in the world where the TB incidence is still rising
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
