National Tuberculosis Prevalence Survey moves into the Eastern Cape

Cape Town | South Africa’s first National Tuberculosis (TB) Prevalence Survey has entered its second leg as fieldworkers visit households around the Eastern Cape to invite eligible community members to participate in a study that aims to determine the prevalence of TB disease in South Africa.

The Survey, commissioned by the National Department of Health and undertaken by the South African Medical Research Council (SAMRC), Human Sciences Research Council (HSRC) and the National Institute for Communicable Diseases (NICD), has reached a 90% participation rate despite the challenging geographical terrain in some rural pockets of the Eastern Cape province.  

“This survey is the first of its kind in the country and people in the Eastern Cape are eager to participate and play their part in reflecting the true burden of tuberculosis in their province,” says Co-Principal Investigator of the survey, Professor Martie van der Walt. “We will be targeting all nine provinces in the country and look forward to participation in the Eastern Cape similar to the high participation rates from KwaZulu-Natal in March 2018.”

With technical support provided by the World Health Organisation (WHO), the survey will draw an estimated 55,000 participants from 110 clusters across the country and will use the latest GeneXpert technology, which is highly sensitive and specific for diagnosing TB. Dr Nazir Ismail, Head of the Centre for Tuberculosis at the NICD explains that the new Ultra cartridge of the GeneXpert molecular assay is exciting as it could diagnose even the lowest bacterial load. This improved sensitivity for diagnosing TB will lead to a more accurate reflection of TB prevalence in the country.

The Survey will also provide information on how people with TB seek care in South Africa. “The survey follows scientifically valid methodologies that have been used globally to determine stigma and other behavioural factors, which impacts on how people seek care,” says HSRC Principal Investigator, Dr Sizulu Moyo. This information will be used by government to change policies and processes in provision of TB services that are more patient-centred.  

 The Survey targets participants who are 15 years and older in the selected areas, its results are expected to be announced in 2019.

TB survey procedure and processes
The HSRC fieldworkers, clearly identifiable through survey attire and identification logos, are visiting randomly selected households to invite community members to participate.  Participation is completely voluntary and the information and confidentiality of each participant is carefully protected.

What can individuals expect should they volunteer to participate?

• Participants will be asked questions about the typical signs and symptoms of TB, 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 that causes TB.
• If there are any TB organisms in the sputum, the result will be provided to the focal TB person of the cluster, who will contact the participant in order to link him/her to care and treatment.

NOTE TO THE EDITOR:

PARTNER ORGANISATIONS:

About the South African Medical Research Council (SAMRC)
The scope of the SAMRC’s research includes basic laboratory investigations, clinical research and public health studies. Research at the SAMRC focuses on the following top 10 causes (www.samrc.ac.za ) of death in South Africa.  To assist with delivering on this vital mandate, the organisation is led by the National Department of Health, and works with other key stakeholders such as the Department of Science and Technology, South African and international science councils, medical schools, universities, research institutions and international collaborators.

About the HSRC
The HSRC was established in 1968 as South Africa’s statutory research agency and has grown to become the largest dedicated research institute in the social sciences and humanities on the African continent, doing cutting-edge public research in areas that are crucial to development.  Our mandate is to inform the effective formulation and monitoring of government policy; to evaluate policy implementation; to stimulate public debate through the effective dissemination of research-based data and fact-based research results; to foster research collaboration; and to help build research capacity and infrastructure for the human sciences.  The Council conducts large-scale, policy-relevant, social-scientific research for public sector users, non-governmental organisations and international development agencies. Research activities and structures are closely aligned with South Africa’s national development priorities. www.hsrc.ac.za

About the National Institute for Communicable Diseases
The National Institute for Communicable Diseases (NICD) is the national public health institute for South Africa (www.nicd.ac.za). It provides reference microbiology, virology, epidemiology, surveillance and public health research to support the government’s response to communicable disease threats. The Centre for TB at NICD serves as the SA National and WHO Supranational Reference Laboratory supporting surveys and specialised diagnostic services in South Africa as well as other countries in Africa. It is also responsible for public health surveillance and response thereby contributing to policy development.

About the World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. In September 2015, South Africa joined world leaders in adopting the Sustainable Development Goals. In line with the Sustainable Development Goals, South Africa is working towards the Global END TB Strategy that aims to end the TB epidemic.  Evidence gathered from the National TB prevalence survey will help determine the baseline for subsequent surveys in the monitoring of TB prevalence over time, and guide policies in the effort to End TB in South Africa. The survey is being conducted according to the international recommendations of the WHO Global Task Force on TB Impact Measurement, Sub-group on Prevalence Surveys, as detailed in the "Lime Book". http://www.who.int/en/

Technical queries:

• Sicelo Dlamini - National Department of Health / Email: sicelo.dlamini@health.gov.za
• Phumlani Ximiya - National Department of Health / Email:  phumlani.ximiya@health.gov.za
• Professor  Martie van der Walt - SAMRC / Email:  vdwalt@mrc.ac.za
• Dr Sizulu Moyo -  HSRC / Email: smoyo@hsrc.ac.za