Project Fact Sheets

In 2017, South Africa notified 227,224 tuberculosis (TB) patients against the World Health Organisation’s (WHO) estimations of 332,000 patients in the same year.  This indicates that an estimated 104,776 TB patients were not diagnosed, notified or ever enrolled in the national treatment programmes. These TB patients have in essence been missed by the country’s health system are therefore referred to as “missing TB patients”. The missing TB patients include patients with undiagnosed TB in communities, or those missed by the health system at the time of diagnosis, treatment or reporting. These system constraints pose a major obstacle to achieving the END TB Strategy targets by 2035 and will require further effort and resources. Missing TB patients therefore remain an urgent priority to find and link to proper care.

To improve the quality of drug-resistant tuberculosis (DR-TB) care and thus treatment success and cure rates, the United States Agency for International Development (USAID) developed A Practical Guide to Delivering Essential Supportive Care to Patients with Drug-resistant Tuberculosis. Many countries are already providing some level of patient support services for DR-TB. Studies show that key barriers to completing DR-TB treatment include poor access to health services and insufficient understanding of the disease and its treatment. Factors such as long treatment timelines; serious side effects of medications, including permanent hearing loss; costs associated with accessing healthcare; pressures on employment; emotional and physical isolation of patients, particularly those dealing with co-morbid conditions, particularly HIV infection; mental illness and substance abuse; high levels of stigma and discrimination experienced by patients and their families; and generally poorer outcomes for patients also contribute to poor treatment outcomes. While South Africa has already made tremendous strides in improving access to DR-TB treatment and care, a 57% treatment success rate for MDR-TB in 2016 is still unacceptably low.   

According to the World Health Organization(WHO), Tuberculosis (TB) contacts are people who have close contact with patients with infectious TB and are therefore at high risk of TB infection.  WHO recommends that TB contacts should be investigated systematically and actively for TB infection and disease through a process called ‘tuberculosis contact investigations’. Many studies in countries with a high TB incidence have shown that the prevalence of TB among household contacts may reach 5 per cent or more. Even studies conducted in South Africa identified a high yield of TB cases among household contacts of TB patients and even higher in HIV infected contacts.

To maximize programmatic synergies and coordination between the USAID TB South Africa Project and district support partners (DSPs) funded by the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), and working in the same priority districts, USAID TB South Africa Project engaged five PEPFAR DSPs: Anova Health Institute, Right to Care, Maternal Adolescent and Child Health (MatCH), Wits Reproductive Health and HIV Institute (WRHI) and Kheth’Impilo, to identify areas of collaboration in implementing tuberculosis (TB)/HIV activities.

When a person is diagnosed with tuberculosis (TB), there is the risk that they have already pass on TB infection to people they live or work with. Those with compromised immune systems such as children, people living with HIV and patients with diabetes are at an even higher risk of becoming infected.