Declining TB Notification Trend Associated with Strengthened TB & Expanded HIV Care in Swaziland

This retrospective observational review documents the efforts of the Swaziland National Tuberculosis (TB) Control Programme between 2004 and 2014. The objective is to describe the disparity between actual declines in case notification and increases in estimated incidence. The review of policies and practices shows the most influential factors associated with the decrease in TB case notification to be an increase in access to antiretroviral therapy for co-infected TB patients, the general success of TB and human immunodeficiency virus service integration in the country and improvements in implementation of all components of directly observed treatment, active case finding, and rapid diagnosis using new technologies.

Below:  Estimated TB incidence, notification and notification by TB category, Swaziland, 1995–2013.1 SM+ = smear-positive; SM− = smear-negative; Unk = unknown; EPTB = extra-pulmonary tuberculosis; TB = tuberculosis

Below:  Comparison of TB case finding against national ART scale-up, Swaziland, 2001–2013.8 TB = tuberculosis; ART = antiretroviral therapy; EPTB = extra-pulmonary tuberculosis; PTB = pulmonary tuberculosis.

Full article at:  http://ht.ly/SZ0ma 

By: S. Haumba,1 T. Dlamini,2 M. Calnan,1 V. Ghazaryan,3 A. E. Smith-Arthur,3 P. Preko,4 and P. Ehrenkranz5

² National Tuberculosis Control Programme, Mbabane, Swaziland

³ University Research Co., LLC, Bethesda, MD, USA

⁴ CTS Global, assigned to US Centers for Disease Control and Prevention (CDC), Mbabane, Swaziland

⁵ 

1 University Research Co., LLC, Mbabane, Swaziland

2 National Tuberculosis Control Programme, Mbabane, Swaziland

3 University Research Co., LLC, Bethesda, MD, USA

4 CTS Global, assigned to US Centers for Disease Control and Prevention (CDC), Mbabane, Swaziland

5 CDC, Division of Global HIV/AIDS, Mbabane, Swaziland

1 University Research Co., LLC, Mbabane, Swaziland

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