The primary aim of the study is to measure the prevalence of bacteriologically confirmed pulmonary TB (PTB) among 26,000 respondents in 54 clusters selected by systematic cluster sampling strategy. Age ≥15 years and residency in households constitute inclusion criteria for participating in the survey. Screening is done by symptoms and chest X-ray, as recommended by World Health Organization (WHO). Two sputum samples will be collected from respondents with cough≥14 days and/or abnormalities in lung (and from subjects who will not perform chest x-ray) and processed at the National Tuberculosis Reference Laboratory (NTRL) Xpert MTB/RIF, liquid culture and identification of Mycobacterium tuberculosis. Samples with no growth after 6 weeks are culture negative. Those with nontuberculous mycobacteria (NTM) growth without co-isolate of mycobacterium tuberculosis are not TB cases. All invited participants will be offered HIV testing. Data will be entered using Redcap. To protect confidentiality, the electronic data base will not bear names. Point estimates and 95% confidence intervals of variables including prevalence of bacteriologically confirmed PTB will be calculated. Preliminary results will be discussed 4-6 months after completing the survey, and a final report will then be generated and disseminated. A Technical Working Group (Clinical practice, Data management, Laboratory representatives etc.) will be responsible for scientific inputs and survey monitoring; a Survey Implementation Team for day-to-day operations; three field teams for data collection; and a Data Management Unit for data management. All survey staffs have been trained to ensure standardization. Benefits and risks of participating will be explained and written informed consent sought from respondents. Ethical Clearance was approved.
The mining sector plays a significant role in the economic growth of Southern Africa. The Republic of South Africa has both the highest number and largest mines in the regions. In South Africa, mining is estimates to a USD1.8 million trillion sector, contributing about 8.6% of South Africa's total annual gross domestic product (GDP). There are about 2,000 registered mining companies in South Africa, and they employ more than 500,000 mine workers. Approximately 40% of the mine workers come from the neighboring countries of Lesotho, Swaziland, and Mozambique. Mine workers in the southern Africa sub-region have one of the highest TB incidence rates in the world. In South Africa, TB incidence is 2500- 3000/100,000 among mine workers— more than three times higher than in the general population (948/100,000) and more than ten times higher than the WHO threshold for characterizing a TB emergency (250/100,000). Mine workers are exposed to a multitude of factors that compound their risk of TB infection. These risk factors include their working conditions (prolonged exposure to silica dust, poor ventilation, exposure to occupational injuries); socio-economic factors (migrant status, cramped and unsanitary living conditions, lack of knowledge of the health system or their rights regarding access to care); and their disease burden (co-exposure to HIV, silicosis, or both). Mine workers frequently travel across provincial and national TB infection in labour-sending areas, and also adversely affects mine workers’ adherence to TB treatment, which contributes to the incidence of drug resistant TB. The World Bank (2014-2015): AQUITY was assigned by the World Bank to conduct training of the healthcare workers on TB in Lesotho, Mozambique, South Africa and Swaziland. This strengthened capacity to implement activities for improved management of TB among miners, ex-miners, their families and surrounding communities. Training emphasis was on infection control, screening, diagnosis, treatment and referral as prescribed by the Framework for Harmonized Management of TB. Among other deliverables, AQUITY: Developed the training modules and materials using the Framework for the Harmonized Guidelines for [...]
The Stop TB Partnership funded by Gates foundation approved a total of USD17million to support 42 grants implemented around the world to fight the TB burden. These projects are expected to develop and apply modern technologies in their case finding, improvement of diagnosis and treatment and support for people will TB. Aquity Innovations is one of the implementing partners focusing on case finding in the identified districts in East London. AQUITY will promote an integrated TB disease management approach by linking people diagnosed and treated in the private sector with the South Africa National TB notification system. This will be achieved by training private General Practitioners as per national TB guidelines and CHWs in Active Case Finding to ensure disrupted TB patient care cascade until cure. The project distinctively links people diagnosed and treated in the private sector with the SA national TB notification system in Nelson Mandela Metro in Eastern Cape Province. The project will link together referring, diagnosis, treatment and adherence providers in a comprehensive and people-centered approach. Core activities will engage and train CHW front line providers to enhance case detection and local General Practitioners (GP) to adhere to the national TB guidelines, diagnose and ensure same-day treatment initiation and follow-up services next to their homes. A consortium of 10 GPs complemented by 20 CHWs will actively screen 150’000 persons with TB symptoms and directly yield 1’000 additional confirmed TB patients with treatment initiated within 48h and followed-up until cure. Through the use of mHealth technologies, Aquity will be able to process field data efficiently and field develop maps through the geo tagging functionality of the application.
Background Diabetes mellitus (DM) is quietly fueling the spread of Tuberculosis (TB).1 DM triples a person’s risk of developing TB, and rates are rising fast in countries with the highest burden of TB, such as South Africa.2 At current projections, Type 2 diabetes will impact nearly 366 million people by 2030.3 TB and DM are two of the world’s leading causes of death and disability. Therefore, successfully addressing TB and DM requires a coordinated response to both diseases at all levels of the health system. However, care for TB and DM are provided in separate health settings in South Africa, resulting in missed opportunities for early diagnosis and treatment of both diseases. Sanofi prides itself as not just being a supplier of pharmaceutical products, but also of being a global healthcare solutions leader, focused on a goal: to improve the lives of patients worldwide.In 2016, Sanofi Global selected University Research Co., LLC to implement a DM/TB project in South Africa to complement and support current National Department of Health (NDoH) programs in TB and DM, and to help develop tools, processes, and methods to enable integrated management of TB and DM. AQUITY Innovations NPC, was one of the sub granted local NGOs during this implementation. Goal and Objectives The goal of the project was to increase early detection and appropriate management of patients with TB and DM comorbidities in high-volume facilities in four provinces of South Africa. The three primary objectives of the project were to: Strengthen health workers’ skills and practices for diagnosis and case management of TB and Integrate diabetes screening with TB services, and TB screening in diabetes service delivery provided by high volume public and private health Increase patients’ awareness about prevention and control of DM and Target Groups The project targets both public and private diabetes and [...]