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Tuberculosis management in Soweto.

L D Saunders, L M Irwig, T D Wilson

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |September 1, 1984
    PubMed
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    Tuberculosis (TB) treatment adherence is low in Soweto, South Africa, with only 28% of patients receiving adequate therapy. However, investigating home contacts of TB patients is effective for case finding.

    Area of Science:

    • Public Health
    • Infectious Diseases
    • Epidemiology

    Background:

    • Tuberculosis (TB) remains a significant public health challenge in South Africa, even in urban areas with developed health services.
    • Effective chemotherapy is available, yet challenges in TB management persist in Soweto.

    Purpose of the Study:

    • To assess the adequacy of TB treatment among known patients in Soweto.
    • To evaluate the effectiveness of investigating home contacts for TB case finding.

    Main Methods:

    • Retrospective analysis of TB patient treatment records and clinic attendance in Soweto.
    • Assessment of home contact investigation rates and subsequent TB notification.

    Main Results:

    • Only 28% of newly notified TB patients received at least 80% of their required first-year treatment.

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  • Infrequent clinic attendance led to inadequate dosages, with 17% of patients over 10 years old still having bacilli in sputum after 4 months.
  • Approximately two-thirds of home contacts were investigated, leading to 5% new TB notifications.
  • Conclusions:

    • Significant challenges exist in ensuring adequate TB treatment completion and dosage in Soweto.
    • Home-contact tracing is a valuable strategy for identifying new TB cases and should be continued.