South Africa is one of the 22 countries globally, that is designated by the WHO as a “TB hot spot” country. Six countries account for 60% of the total TB cases, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa. The number of TB cases reported in South Africa was relatively stable between 1980 and 1989. Fuelled by the rise in HIV prevalence, the number of TB cases increased from 68,027 TB cases (187/100,000) in 1989 to 188,695 TB cases (424/100,000) in 2001, an increase of 276% and a prevalence of 768 per 100 000 a decade later. The total cases notified in 2016 were 244,053 (new and relapse cases) with a TB/HIV incidence of 461/100,000.
In 2016 an estimated 1.3 million people who were HIV negative died of TB. In addition there were 374,000 deaths resulting from TB disease among people who were HIV positive. So there were a total of 1,674,000 TB related deaths.
An estimated 250,000 children died of TB in 2016 including children with HIV associated TB.
People who have both TB and HIV when they die, are internationally classified as having died from HIV. Forty percent of HIV deaths were due to TB.
In 2016 only 6.3 million cases of TB were reported, but there were globally an estimated 10.4 new cases of TB. So where are these “missing” four million? How can they be found and provided with treatment?
A serious complication to the Tuberculosis epidemic in South and southern Africa has been the emergence of multi-drug resistant (MDR) strains or extensively drug resistant TB (XDR TB).
Estimated WHO Regional TB statistics for 2016
| WHO Region |
Total |
TB Mortality Male 0 - 14 Years |
TB Mortality Female 0 - 14 Years |
TB Mortality Male > 14 Years |
TB Mortality Female > 14 Years |
| Africa |
320,000 |
23,000 |
20,000 |
177,000 |
100,000 |
| Americas |
6,200 |
1,000 |
0.860 |
2,900 |
1,500 |
| Eastern Mediterranean |
3,000 |
0.260 |
0.210 |
1,400 |
1,100 |
| Europe |
5,100 |
0.47 |
0.390 |
3,000 |
1,200 |
| South-East Asia |
35,000 |
2,400 |
0.20 |
20,000 |
9,900 |
| Western Pacific |
5,000 |
930 |
0.78 |
2,200 |
1,000 |
| Global Total |
374,000 |
28,000 |
24,000 |
207,000 |
115,000 |
https://www.tbfacts.org/tb-statistics/
SA has the means to overcome the TB epidemic situation and the following will have a substantial impact on TB control:
- Implementation of the basics of TB diagnosis and treatment
- Scaling up the use of Xpert MTB/RIF as a replacement for sputum smear microscopy
- Strengthening case finding in and beyond healthcare facilities
- TB prevention for people living with HIV, particularly earlier initiation of and scaling up antiretroviral therapy and scaling up continuous isoniazid preventive therapy
- Introduction and the use of new TB drugs, diagnostics and vaccines to further accelerate progress towards improved TB control in SA and beyond.
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