South Africa can reduce TB deaths by testing more people
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Researchers in South Africa determined that increasing tuberculosis (TB) testing among people reporting symptoms is the most effective way to lower TB rates and deaths.
A new modelling study, building on the existing Thembisa model of HIV and TB, found that testing 89% of symptomatic people with new, easier point-of-care tests could reduce new TB cases by 49% and TB deaths by 67%.
Currently, testing rates in South African clinics vary widely, with a median of only 30% of symptomatic patients receiving a test. The study also examined other interventions. Researchers found door-to-door testing with the new tests could reduce new cases and deaths by 38% and 49% respectively, while combining this with digital chest X-rays could lower cases by 17% and deaths by 21%. Even increasing existing sputum testing, which can be difficult for some patients, could reduce new cases by 29%.
The World Health Organisation recently recommended these new point-of-care tests, which can use sputum or tongue swabs, but they are not yet widely available in South Africa. The study emphasizes the importance of strengthening testing guidelines, increasing the healthcare workforce dedicated to TB diagnosis, and improving monitoring systems to ensure symptomatic patients are tested. While South Africa isn't on track to meet its 2030 TB reduction targets, the researchers believe increased testing can help close the gap.
