South Africa is burdened by one of the worst tuberculosis epidemics in the world, with rates more than double those observed in other developing countries .
--- where the incidence of new case increased by up to 180 per cent
in the 1980's --- looks to South Africa for leadership in solving
the TB problem, but the shocking truth
is that the incidence of the disease in South Africa is among the highest
in the world. The Word Health Organization calls 120 case per 100
000 people an epidemic. In South Africa , the average figure is 226 per
100 000 and in parts of the Western Cape it reaches 670 cases per
Tuberculosis was declared a top health priority by the South African Department in Health in November 1996 and the Minister of Health committed the Department to implement a new control programme based on the directly observed treatment short-course (DOTS) of the World Health Organization.
It is predicted that the number of tuberculosis in Sub-Saharan Africa will double by the year 2000.
Poor living conditions and overcrowding
contributed to the spread of tuberculosis in southern Africa in the late
19th and early 20th century.
The introduction of anti-tuberculosis drugs in the 1950's resulted in a sharp decline in tuberculosis death rates although the incidence rates continued to rise.
The TB epidemic did not affect the working class evenly but largely affected the black workers. It is argued that inefficient treatment programmes have produced a growing pool of half-cured, potentially infective cases which contribute to the rise of tuberculosis and the developement of drug resistance.
South Africa has one of the highest tuberculosis incidence rates in the world. It is thought that nearly half of the 42 million people are infected with TB of which 10% would normally develop tuberculosis.
The high incidence of acquired immume defficiency syndrome(AIDS),especially amongst Black communities,leads to much higher tuberculosis figures. This does not bode well for the future of tuberculosis control in South Africa where the health authorities predict a 10-20 percent yearly increase of tuberculosis due to the prescence of HIV in the population.
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