On 1 July 2010 Dr Alex Welte becomes the new Director of SACEMA. Alex trained in theoretical and computational physics, first in South Africa, at the University of the Witwatersrand, and then in the United States, where he did his doctorate at the University of Pennsylvania. Returning to South Africa, Alex played an important role Read More
In the last 20 years the number of new tuberculosis (TB) cases had tripled in high HIV prevalence countries, and at least a third of the world’s 33.2 million persons living with HIV/AIDS (PLWHA) are infected with TB. Approximately 80% of people with TB/HIV infections live in sub-Saharan Africa, where TB is the leading cause Read More
Although mortality is high among patients infected with both tuberculosis (TB) and HIV, there is debate on the best moment to start antiretroviral treatment (ART) when patients are on TB therapy. A study recently published in the New England Journal of Medicine reports on a randomised controlled trial (RCT) conducted in Durban (1). Patients diagnosed Read More
The central theme of this SACEMA Quarterly is the HIV/TB co-epidemic. From 1-4 June 2010 the 2nd TB conference was held in Durban, in which most of the presentations discussed TB in relation to HIV. A SACEMA affiliate presented a study concluding that intensified HIV testing and early initiation of antiretroviral therapy (ART) for women and men aged 25-40 would optimise the cost-effectiveness of applying the test-and-treat strategy in South Africa, as this would have the largest impact on TB as well. One of the main articles in this Quarterly discusses whether ART will help, and to what extend, in lowering TB incidence. Other articles focus on meaningful statistical modelling in public health, and the Zibambele programme (job creation and poverty alleviation) and it’s role in the battle against HIV/AIDS and TB. Finally, the new director of SACEMA is announced: Dr. Alex Welte.
One of the major obstacles to meeting the Millennium Development Goals is the HIV-associated epidemic. Of the estimated 9.3 million new TB cases that occurred worldwide in 2007, 1.37 million (14.8%) were associated with HIV. Sub-Saharan Africa has borne the burden of this co-epidemic. South Africa alone accounts for a staggering one in four of the world’s cases of HIV-associated TB. This article gives an answer to the question why traditional TB control strategies have failed; what other interventions could do; what the possible TB preventive impact of antiretroviral therapy could be and how ART could be optimally used.
Mathematical modelling is valuable in public health because it for example provides a way to evaluate strategies for controlling disease before actually trying such strategies in the field. By varying the values of model parameters, it is possible to ask questions such as: “How will the number of people getting sick during an influenza outbreak in Cape Town be affected if we give half of all sick people a drug that reduces their infectiousness by 50%?”. In May 2009, the first annual clinic on the Meaningful Modelling of Biological Data was organised at the African Institute for Mathematical Sciences (AIMS) in Muizenberg, South Africa.