There are few students in epidemiological modeling and analysis who can resist the temptation to fit a theoretical disease model to real epidemic data. A recent DNA fingerprinting project from Masiphumelele, a township near Cape Town, offered such a temptation. The result is a short journey into the world of statistically rare events, in this case brought about by the relatively small size of Masiphumele and by the slow reactivation rates of TB.
Transmission of tuberculosis (TB) involves random processes operating at two very different levels. On the one hand, an infectious person must be in reasonably close proximity to a susceptible person for a minimum period of time (macro-level). On the other hand, minute droplets containing bacteria entities that are exhaled by the infectious person are inhaled by the recipient (micro-level). At both these levels the chance events can be described by a statistical formula, the Poisson distribution. An analysis of these two processes in this way reveals a surprising phenomenon that manifests in communities experiencing high incidences of TB disease.
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.
The article from Tony Davies in this issue of the Quarterly, gives a historical overview on occupational lung disease in South Africa. Recently a report was published by the Health Systems Trust, which highlights the actuality of this topic (2). The aim of the research presented in the report was to investigate health systems surveillance Read More
South Africa is faced with a public health catastrophe due, in part at least, to the mining activity, which laid the foundation of our economy. In the mines millions of men have worked in dangerous and dusty conditions. There have been three very high risk exposures in South African workplaces: silica, asbestos and tuberculosis, all resulting in serious lung problems. This article gives an historical perspective on the causes of occupational lung disease and what should have been done to lower the risks.
In this third issue of the SACEMA Quarterly, the focus is not on HIV/AIDS, but on other infectious diseases. The first article reports on the prevention of sleeping sickness, by catching away the tsetse flies causing the disease, using baits. The second one presents the Global Fund’s approach to combating Malaria: The Affordable Medicines Facility-Malaria (AMFm), which mainly comes down to reducing the prices of malaria treatment by means of subsidy. And the last article discusses the status of tuberculosis in South Africa.
On World TB day, March 24th, the WHO released its new global tuberculosis (TB) report. The important role of HIV in TB infection is highlighted by the fact that as many as a quarter of TB deaths occur in patients with HIV infection, twice as many as previously recognized. The report indicates that there are Read More
Dr. Alex Welte, visiting research fellow at SACEMA, attended the XVI Conference on Retroviruses and Opportunistic Infections in February this year in Canada and presents you the highlights. South and Southern Africa were well represented. James McIntyre and Glenda Gray held the address on the openings day on responding to the HIV Epidemic in Soweto. Read More
The fifth forum of the European and Developing countries clinical trials partnership (EDCTP) will take place from 12 to 14 October 2009 in Arusha, Tanzania. The Forum’s theme reflects the global call for all partners and stakeholders to work together to rid the world the suffering of these diseases of poverty. Researchers involved in clinical Read More
It gives me great pleasure to introduce to you the first issue of a Quarterly Magazine produced by SACEMA – the DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis. It is our aim to provide regular updates, articles and reviews of developments in the world of quantitative epidemiology – with particular reference to the human health in the South African scene and to advances in the fight against the twin scourges of HIV and TB.