The CTB uses an integrated approach, combining public health surveillance and reference laboratory functions to provide enhanced and strategic information to guide TB control activities for South Africa. National surveillance covers new cases of laboratory-confirmed TB as well as new drug-resistant TB, including rifampicin-resistant (RR), multidrug-resistant (MDR) and extensively drug- resistant (XDR) cases identified by NHLS laboratories which serve over 80% of the population. Surveillance findings are regularly analysed and reported to the National TB Programme (NTP) and have assisted in monitoring the 90:90:90 strategic targets of the DoH. Information on drug resistance prevalence determined through a national survey has been analyzed and will guide the NTP in pursuit of the Sustainable Development Goals, providing direction in terms of human and financial resources for areas of need.

New specialised molecular techniques for Mycobacterium tuberculosis detection have now been integrated into the surveillance system to better define drug resistance mutation profiles and clonal strains, using whole genome sequencing (WGS), restriction fragment length polymorphism (RFLP) typing, spoligotyping and mycobacterial interspersed repetitive unit (MIRU) typing, all of which have become well established and are producing important findings. In addition, the centre is playing a leading role globally in the development and application of methods for drug resistance determination for new anti-mycobacterial agents, particularly bedaquiline.

Surveillance Activities: