Tuberculosis

Published on June 15, 2017 by

HIV infection and tuberculosis mortality among adults in Cape Town

Although a curable disease, tuberculosis (TB) remains a significant cause of mortality worldwide. To create a basis for further research into TB and HIV-associated mortality in Cape Town, we conducted a retrospective analysis of deaths occurring during TB treatment. A binomial log-linear regression model was used to investigate risk factors associated with death during TB treatment. We specifically looked at interactions between HIV infection and various other risk factors towards the risk of death from TB during treatment.

Published on December 9, 2016 by

Editorial: HIV, TB and malaria: Is the end in sight?

The history of sub-Saharan Africa has been defined and determined to a large extent by the struggle against tropical diseases, many of them vector borne, including malaria, leishmaniasis, trypanosomiasis and many others. To add to this burden our continent has now to deal with the ravages of HIV and the consequent rise in tuberculosis. In this issue of the SACEMA Quarterly we discuss some of the key problems and ways in which we might be able to address and mitigate some of the challenges that we face in this regard.

Published on June 15, 2016 by

High risk of reinfection TB in hyperendemic settings: Reasons and remedies.

It is known that in high TB incidence settings the rate of recurrent TB disease is much higher than the rate for first-time disease. It is not clear why the rate of reinfection disease can be elevated compared to the rate of primary disease. We set about attempting to estimate the actual values of the risk of reinfection and the rate of progress to disease for the high-incidence community of Ravensmead-Uitsig in Cape Town.

Short item Published on March 10, 2016

Update: Compensating miners for the burden of lung disease

In the SACEMA Quarterly of November 2015 we published an item from Alide Dasnois about compensating miners for the burden of lung disease. On 6 March 2016 City Press published an article titled “Silicosis claims: Anglo has to cough up nearly R500m” which reports on a first step in the process of paying the individual claims.

Short item Published on November 30, 2015

Compensating miners for the burden of lung disease

Alide Dasnois, a South African journalist and former editor of the Cape Times, has written an an article titled “The long battle to get the mines to cough up” which is about compensating miners for the burden of lung disease. The importance of this issue has been highlighted before in a SACEMA Quarterly article by Tony Davies giving an historical overview on occupational lung disease in South Africa.

Published on March 18, 2013 by

Sputum smear-positive tuberculosis among previously treated individuals in the Western Cape Province, South Africa

A considerable share of South Africa’s tuberculosis burden affects those people who have previously been treated for tuberculosis – many of them successfully. In a retrospective cohort study that was conducted using tuberculosis treatment register data from two communities in suburban Cape Town, it was found that the hazard rate of re-treatment for smear-positive tuberculosis was between 3- and 5.26-times higher in tuberculosis cases who had defaulted from treatment compared to successfully treated cases. But although the rate of re-treatment was substantially higher among defaulters, cases after treatment success account for the vast majority of smear-positive re-treatment cases due to the fact that far more tuberculosis cases were successfully treated than had defaulted.

Short item Published on March 18, 2013

Understanding TB latency using computational and dynamic modelling procedures

The Mycobacterium tuberculosis (TB) bacilli’s potency to cause persistent latent infection that is unresponsive to the current cocktail of TB drugs is strongly associated with its ability to adapt to changing intracellular environments, and tolerating, evading and subverting host defence mechanisms. We applied a combination of bioinformatics and mathematical modelling methods to enhance the understanding Read More

Published on November 30, 2012 by

Projecting the impacts of Xpert MTB/RIF using virtual Implementation

The introduction and scale-up of new tools for the diagnosis of tuberculosis (TB) has the potential to make a huge difference to the lives of millions of people. To realise these benefits and make the best decisions, policy makers need answers to many difficult questions about which new tools to implement and where in the diagnostic algorithm to apply them cost effectively. Here we explore virtual implementation as a tool to predict the health system, patient, and community impacts of alternative diagnostics and diagnostic algorithms for TB, in order to facilitate context specific decisions on scale-up. Virtual implementation is an approach that can model the impacts of implementation of a new diagnostics by taking data from the context being considered alongside data from contexts where the new technology has been implemented (probably as a trial).

Published on September 12, 2012 by

The use of clusters to estimate recent transmission of TB

A new case of TB is the outcome of a recent infection event (primary TB) or is the result of the reactivation of a latent infection acquired some years previously. In a community where TB is endemic it is important to know the extent to which primary cases contribute to the overall burden as this can inform strategies to deal with the epidemic. This article discusses the methods for estimating the proportion of cases due to recent transmission by using cluster analysis. Sputum specimens from cases reporting to clinics are cultured and the TB strains are identified, commonly using molecular techniques of DNA ‘fingerprinting’. By comparing these fingerprints from various patients it becomes possible to classify them as unique or clustered. The proportion of clustered individuals can then be used as an indicator of the proportion of on-going or recent transmission.

Short item Published on June 13, 2012

More XDR TB among patients with HIV

Although antibiotics have saved millions of lives, their use and misuse has often led to the development of resistance in the agents that they are intended to fight. SACEMA's Brian Williams recently published a commentary on an article in published in Science Translational Medicine in which Sergeev et al. used dynamical models to investigate the Read More

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