Title: Space-time clustering of recently diagnosed tuberculosis and impact of ART scale-up: Evidence from an HIV hyper-endemic rural South African population
Authors: Tomita A, Smith CM, Lessells RJ, Pym A, Grant AD, de Oliveira T, Tanser F .
Journal: Scientific Reports,https://doi.org/10.1038/s41598-019-46455-7: (2019)
In HIV hyperendemic sub-Saharan African communities, particularly in southern Africa, the likelihood of achieving the Sustainable Development Goal of ending the tuberculosis (TB) epidemic by 2030 is low, due to lack of cost-effective and practical interventions in population settings.
We used one of Africa's largest population-based prospective cohorts from rural KwaZulu-Natal Province, South Africa, to measure the spatial variations in the prevalence of recently-diagnosed TB disease, and to quantify the impact of community coverage of antiretroviral therapy (ART) on recently-diagnosed TB disease. We collected data on TB disease episodes from a population-based sample of 41,812 adult individuals between 2009 and 2015. Spatial clusters (hotspots') of recently-diagnosed TB were identified using a space-time scan statistic. Multilevel logistic regression models were fitted to investigate the relationship between community ART coverage and recently-diagnosed TB.
Spatial clusters of recently-diagnosed TB were identified in a region characterized by a high prevalence of HIV and population movement. Every percentage increase in ART coverage was associated with a 2% decrease in the odds of recently-diagnosed TB (aOR?=?0.98, 95% CI:0.970.99).
We identified for the first time the clear occurrence of recently-diagnosed TB hotspots, and quantified potential benefit of increased community ART coverage in lowering tuberculosis, highlighting the need to prioritize the expansion of such effective population interventions targeting high-risk areas.
Citation: Tomita A, Smith CM, Lessells RJ, Pym A, Grant AD, de Oliveira T, Tanser F . Space-time clustering of recently diagnosed tuberculosis and impact of ART scale-up: Evidence from an HIV hyper-endemic rural South African population Scientific Reports,https://doi.org/10.1038/s41598-019-46455-7: (2019).
Groundbreaking study on KZN community gives new hope to fight TB - Daily News - 2019-08-07
A ground breakin study conducted by scientist from the University of KwaZulu-Natal (UKZN), the KwaZulu-Natal Research Innovation & Sequencing Platform (KRISP) and the Africa Health Research Institute (AHRI) has given new hope to policy makers on the frontline of the fighting the disease that proves that scaling up antiretroviral therapy (ART) coverage can reduce the cases of TB.
KRISP has been created by the coordinated effort of the University of KwaZulu-Natal (UKZN), the Technology Innovation Agency (TIA) and the South African Medical Research Countil (SAMRC).