Tuberculosis prevention in South Africa

Area of Science:

• Epidemiology
• Public Health
• Mathematical Modeling

Background:

• South Africa faces a high burden of tuberculosis (TB) incidence globally.
• A National Strategic Plan (NSP) was established in 2012 to combat TB, aiming for zero new infections and deaths by 2032.

Purpose of the Study:

• To assess if NSP targets for TB control in South Africa are achievable.
• To evaluate the impact of scaling up control methods immediately in 2014.

Main Methods:

• Utilized a transmission model to simulate TB spread and intervention impacts.
• Compared four intervention portfolios: NSP strategy, WHO guidelines, Novel Strategies, and an Optimised approach.

Main Results:

• NSP targets are unlikely to be met even with immediate, scaled-up interventions.
• The 'Optimised' and 'NSP' portfolios showed the most significant impact on TB incidence.
• Active case finding and reducing pre-treatment loss to follow-up were identified as highly effective individual interventions.

Conclusions:

• Existing TB control strategies can significantly reduce disease burden in South Africa.
• New technologies may be necessary to achieve ambitious South African TB targets.
• Intensifying case finding and treatment initiation are crucial for dramatic TB incidence reduction.