Tuberculosis management in Soweto.
Despite the availability of highly effective therapy, tuberculosis (TB) remains a major problem in South Africa, even in urban centres such as Soweto which is relatively well provided with health services. We therefore assessed two aspects of TB management in Soweto: (i) the proportion of known tuberculous patients adequately treated; (ii) whether case finding through investigation of home contacts of notified patients was effective. In 1978 patients with TB were required to take chemotherapy for at least a year. Only 28% of newly notified patients attended the clinics frequently enough and/or were hospitalized long enough to obtain 80% or more of the treatment they required during that first year. A major part of this problem of non-compliance was infrequent attendance; these patients received therapy of an adequate duration, but at an inadequate dosage. At least 17% of patients over 10 years of age had tubercle bacilli in their sputa on microscopy more than 4 months after therapy was started. About two-thirds of known home contacts were investigated by the health services in accordance with their stated policy, and 5% of contacts were subsequently notified. Home-contact tracing therefore seems worthwhile.
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000553:Ambulatory Care; D044383:Black People; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D013019:South Africa; D013223:Statistics as Topic; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D014505:Urban Population