Microbiologically confirmed pulmonary TB: 2004-2015
Electronic TB surveillance has been developed to provide trend analysis and relevant epidemiological data on TB in South Africa. The utility of the surveillance was demonstrated in the article titled Nationwide and regional incidence of microbiologically confirmed pulmonary tuberculosis in South Africa, 2004-12: A time series analysis, published in the Lancet Infectious Disease Journal in 2015. The activities described in this publication have formed the basis for surveillance reporting to the national and provincial Departments of Health on a quarterly basis, and provided information toWHO for the annual Global TB Report. Additional tasks have been undertaken, including trend analysis of drug resistant TB, and early assessment has shown an upward trend in RR TB. However, this is paralleled by an increased rate of testing for drug resistance. The initial introduction of mycobacteria growth indicator tube (MGIT)-based drug susceptibility testing (DST), followed by the line probe assay (LPA) and most recently the Xpert MTB/RIF system have been important contributors to improved detection of drug resistant TB. Further programme planning, adjusting for testing rates and methodologies, is in progress and will assist in contextualising the results of the DRS and in addition present a potential avenue for monitoring trends in drug-resistant TB into the future. The electronic TB surveillance system has proven to be a powerful tool in guiding TB control efforts; however, because the epidemic is heterogeneous, a more comprehensive understanding of the changes over time has facilitated efforts to geospatially map hotspots and will in future allow targeted interventions to be applied.