Tuberculosis prevention in South Africa.
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Author(s)
Type
Journal Article
Abstract
South Africa has one of the highest per capita rates of tuberculosis (TB) incidence in the world. In 2012, the South African government produced a National Strategic Plan (NSP) to control the spread of TB with the ambitious aim of zero new TB infections and deaths by 2032, and a halving of the 2012 rates by 2016.We used a transmission model to investigate whether the NSP targets could be reached if immediate scale up of control methods had happened in 2014. We explored the potential impact of four intervention portfolios; 1) NSP represents the NSP strategy, 2) WHO investigates increasing antiretroviral therapy eligibility, 3) Novel Strategies considers new isoniazid preventive therapy strategies and HIV Universal Test and Treat and 4) Optimised contains the most effective interventions.We find that even with this scale-up, the NSP targets are unlikely to be achieved. The portfolio that achieved the greatest impact was Optimised , followed closely by NSP . The WHO and Novel Strategies had little impact on TB incidence by 2050. Of the individual interventions explored, the most effective were active case finding and reductions in pre-treatment loss to follow up which would have a large impact on TB burden.Use of existing control strategies has the potential to have a large impact on TB disease burden in South Africa. However, our results suggest that the South African TB targets are unlikely to be reached without new technologies. Despite this, TB incidence could be dramatically reduced by finding and starting more TB cases on treatment.
Date Issued
2015-04-07
ISSN
1932-6203
Publisher
Public Library of Science
Start Page
e0122514
Journal / Book Title
PLoS One
Volume
10
Issue
4
Copyright Statement
© 2015 Knight et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Description
21.05.15 KB. OK to add published oa paper to spiral
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/25849558
PONE-D-14-50603
Coverage Spatial
United States