The TB case notification rate in the Africa Centre for Population Health population is amongst the highest in the world, and is inextricably linked to HIV infection. The Africa Centre for Population Health has documented the impact of the TB epidemic on the local population, with TB responsible for an estimated one-third of all deaths in the demographic surveillance area (DSA) between 2000 and 2011. Up to 50% of TB-affected households face catastrophic costs due to TB. The area has the highest proportion of rifampicin-resistant TB Xpert MTB/RIF results in the country. More than half of the registered DR-TB cases in the DSA in 2013-14 had no prior history of TB treatment, suggesting ongoing transmission of DR-TB in the community. Thus transmission of TB, and particularly of multi-drug resistant (MDR) TB, is a key public health challenge for the population under surveillance by Africa Centre for Population Health.

What we’ll do

Our TB programme framework will provide opportunities to address complementary basic science questions through our close links with K RITH and University of Cape Town. This includes the development and subsequent use of biomarkers of early disease and the evolution of drug resistance during treatment.

Our priorities:

  1. To understand transmission of drug-sensitive and drug-resistant TB
  2. To develop interventions aiming to interrupt transmission, and methodology to measure their impact
Figure 2: TB case notification rate, Hlabisa sub-district, 1989-2013