Eight years of tuberculosis research in Hlabisa--what have we learned?
An 8-year research-service collaboration in tuberculosis (TB) in Hlabisa has yielded important data on the emerging HIV-related TB epidemic in South Africa, demonstrating a substantial increase in caseload, HIV prevalence and mortality. A successful, cost-effective, community-based programme of directly observed therapy, utilising volunteers, clinics and community health workers, has helped ensure adherence to therapy. As the caseload has increased, however, case-holding has started to fall, suggesting the need for more effective defaulter-tracing strategies. More fundamental work has studied the molecular epidemiology of TB, suggesting that much of the disease is recently, and casually, transmitted. This collaborative experience may be a model for efforts to control other important public health problems.
Wilkinson
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Medical Research Council, Centre for Epidemiological Research, Southern Africa.
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D003150:Community Health Workers / Q000706:statistics & numerical data / Q000639:trends; D019468:Disease Management; D004351:Drug Resistance; D006801:Humans; D010349:Patient Compliance; D012189:Retrospective Studies; D012423:Rural Health / Q000639:trends; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology