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TB Statistics for South Africa – National & provincial

National TB statistics for South Africa

TB incidence

South Africa is one of the countries with the highest burden of TB, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.1Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en So about 0.8% of the population of about 54 million develop active TB disease each year.

The TB incidence for any country is the number of new cases, usually of active TB disease that have occurred in the country during a certain time period which is usually a year. Out of the 454,00 incident cases in South Africa in 2015, it is estimated by WHO that about 57% (258,000) are HIV positive.

It is also estimated that of 157,505 whose status is known, and who are known to be HIV positive, some 85% (133,116) are on antiretroviral therapy.2Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en For more HIV figures see HIV South Africa and for more about HIV generally see HIV & TB in South Africa.

Latent TB

It is also estimated that about 80% of the population of South Africa is infected with TB bacteria, the vast majority of whom have latent TB rather than active TB disease. The highest prevalence of latent TB, estimated at 88% has been found among people in the age group 30-39 years old living in townships and informal settlements.3National Strategic Plan on HIV, STIs and TB 2012-2016, South African National AIDS Council, 2011 www.gov.za/documents/national-strategic-plan-hiv-stis-and-tb-2012-2016

Mortality

TB continues to be the leading cause of death in South Africa (further details are given below). WHO gives a figure of 25,000 deaths from TB in South Africa in 2015 but this excludes those people who had both TB and HIV infection when they died.4Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en These people are internationally considered to have died of HIV.

Statistics for incidence rate of TB nationally by province and by year

The TB incidence rate is the proportion of new TB cases per 100,000 population over a year. In South Africa the TB incidence rate reached its peak in 2009 at 832 per 100,000, and has since declined.

National incidence rate by year
2015 2014 2013 2012 2011 2010 2009 2008 2007
South Africa 520 593 649 690 762 718 832 753 608

The Eastern Cape, KwaZulu-Natal and the Western Cape are the provinces which have the highest incidence rates in South Africa with reported rates of 692, 685 and 681 per 100,000 respectively. The most notable decline has been in KwaZulu-Natal where the incidence has decreased from 1,185 to 685 per 100,000 over the last five years.

Incidence rate by province and year
2015 2014 2013 2012 2011 2010 2009 2008 2007
Eastern Cape 692 785 823 863 914 922 953 963 807
Free State 575 632 721 761 842 837 860 890 844
Gauteng 330 378 403 418 454 114 517 490 174
KZN 685 814 953 1060 1185 1162 1216 928 881
Limpopo 301 334 383 372 411 420 434 397 329
Mpumalanga 402 462 477 513 614 716 745 637 227
North West 528 631 658 705 817 894 904 815 767
Northern Cape 645 764 798 758 894 892 933 936 859
Western Cape 681 710 743 777 827 910 930 948 938

Statistics for treatment outcomes of new TB cases nationally and by province

National treatment success rate 2012 -2014

TB national treatment success rate
2014 2013 2012
Number of TB patients started on TB treatment 325,498 339,379 354,270
Number of patients successfully treated 251,344 264,455 269,624
Treatment success rate % 77.2 77.9 76.1

National TB cure rate (new pulmonary smear positive) 2012 -2014

The cure rate is the number of cases per 100,000 population where the patient has finished the course of treatment, and there is bacteriological evidence that this has been successful. The treatment success rate is the combination of the cure rate, added to the rate of completion where the course of TB drugs has been completed but there isn’t bacteriological evidence of success. In other words both “success” and “cure” is when the course of drugs has been completed, and for “cure” there in addition has to be bacteriological evidence.

TB national treatment cure rate
2014 2013 2012
Number of new smear positive patients cured 74,737 89,368 92,685
Total number of new smear positive patients 96,607 116,349 122,302
Cure rate for new smear positive TB (%) % 77.4 76.8 75.8

National TB lost to follow up rate (new pulmonary smear positive) 2014

The TB lost to follow up rate measures the proportion of new pulmonary smear positive TB patients who interrupted treatment for two consecutive months or more.

The national lost to follow up rate was 5.6% in South Africa in 2014. This was a marginal improvement from 5.8% in 2013.

Treatment outcomes by province

TB treatment outcomes in South Africa by province 2014.

New smear positive treatment outcomes for TB in South Africa by province 2014
Province Treatment success rate % Cure rate % Lost to follow up %
Eastern Cape 76.2 72.2 6.5
Free State 78 76.2 5.2
Gauteng 83.4 66.7 4.8
KZN 73.8 78.7 4.0
Limpopo 71.8 76.8 4.9
Mpumalanga 84 79.8 3.8
North West 70.2 76.4 5.7
Northern Cape 71.2 69.4 7.3
Western Cape 81.8 78.7 8.8

TB death rate in South Africa 2010 – 2014

TB remained the leading cause of death in South Africa in 2014 with 8.4% of deaths nationally attributed to TB.5Statistics South Africa. Mortality and causes of death in South Africa 2014. Findings from death notifications. Pretoria: StatsSA 2015 However, the proportions of deaths due to TB has decreased significantly since 2007 when it peaked at 12.8%.

TB as cause of natural death by year
2014 % 2013 2012 2011 2010
South Africa 8.4 8.8 9.9 10.7 11.6

TB as cause of death by province & year

TB as cause of death by province & year
2014 % 2013 % 2012 % 2011 % 2010 %
Eastern Cape 9.0 9.8 10.8 11.4 12.7
Free State 8.4 8.5 9.3 9.6 11.1
Gauteng 6.7 7.3 7.7 8.4 8.8
KZN 11.2 11.9 13.3 14.4 15.7
Limpopo 7.4 7.7 8.5 9.1 8.4
Mpumalanga 9.8 10.6 12.0 13.4 13.4
North West 8.9 8.7 10.4 11.3 12.3
Northern Cape 7.4 7.7 8.8 8.5 9.2
Western Cape 5.6 5.7 6.4 7.1 7.8

You can read more about

Drug resistant TB in South Africa

or HIV statistics for South Africa

or TB and HIV in South Africa

Major source for TB statistics for South Africa

District Health Barometer 2015/16 Massyn N, Peer N, English R, Padarath A, Barron P, Day C, editors, District Health Barometer 2015/16 Durban Health Systems Trust; 2016 www.hst.org.za/publications/Pages/HSTDistrictHealthBarometer.aspx

References

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1. Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en
2. Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en
3. National Strategic Plan on HIV, STIs and TB 2012-2016, South African National AIDS Council, 2011 www.gov.za/documents/national-strategic-plan-hiv-stis-and-tb-2012-2016
4. Global Tuberculosis Control 2016, WHO, Geneva, 2016 www.who.int/tb/en
5. Statistics South Africa. Mortality and causes of death in South Africa 2014. Findings from death notifications. Pretoria: StatsSA 2015