Tuberculosis control in South Africa: reasons for persistent failure

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Date
2005
Authors
Van Rensburg, Dingie
Janse van Rensburg-Bonthuyzen, Ega
Heunis, Christo
Meulemans, Herman
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
English: This study reviews the origins and spread of tuberculosis in South Africa in the international context. It shows that TB is far from being under control, despite the availability of effective technology. Five arguments offer explanations for this failure. First, control strategies fail to eradicate the macro-conditions that create a breeding ground for TB. Secondly, new disease conditions — especially HIV/AIDS and MDRTB — confound efforts at control. Thirdly, the health system and its priorities are insufficiently focused and resourced to cope with TB. Fourthly, healthcare staff responsible for TB care are often weak links in the chain of control. Fifthly, TB patients fail due to ignorance, delay in seeking care, and non-adherence to treatment regimens. TB consequently remains a major public health challenge, today more than ever in its protracted history.
Afrikaans: Hierdie bydrae gee ’n oorsig van die oorsprong en verspreiding van tuberkulose in Suid-Afrika teen die agtergrond van die internasionale gemeenskap. Dit toon dat TB hoegenaamd nie onder beheer is nie ten spyte van die beskikbaarheid van doeltreffende tegnologie. Vyf argumente word vir hierdie mislukking aangevoer. Eerstens faal be- heerstrategieë om daardie makro-omstandighede uit te wis wat die teelaarde vir TB daarstel. Tweedens, nuwe siektetoestande — veral MIV/VIGS en MDRTB — bemoeilik kontrolepogings. Derdens, die gesondheidsisteem en -prioriteite is nie genoegsaam gefokus en toegerus om TB suksesvol te hanteer nie. Vierdens, gesondheidspersoneel verantwoordelik vir TB-sorg is dikwels swak skakels in die kontroleketting. Vyfdens, TB-pasiënte faal dikwels deur hul onkunde, uitstel om behandeling te soek, en deur nie behandelingsvoorskrifte te volg nie. Gevolglik bly TB ’n hoof openbare gesondheids- probleem, vandag meer as ooit tevore in sy uitgerekte geskiedenis.
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Keywords
South Africa, Tuberculosis control, Public health
Citation
Van Rensburg, D., Janse van Rensburg-Bonthuyzen, E. J., Heunis, C., & Meulemans, H. (2005). Tuberculosis control in South Africa: reasons for persistent failure. Acta Academica, (Supplement 1), 1-55.