Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 21;5(2):103-5.
doi: 10.5588/pha.15.0008. Epub 2015 May 8.

Declining tuberculosis notification trend associated with strengthened TB and expanded HIV care in Swaziland

S Haumba  1 , T Dlamini  2 , M Calnan  1 , V Ghazaryan  3 , A E Smith-Arthur  3 , P Preko  4 , P Ehrenkranz  5
Affiliations

Declining tuberculosis notification trend associated with strengthened TB and expanded HIV care in Swaziland

S Haumba et al. Public Health Action. .

Abstract
in English, French, Spanish

This retrospective observational review documents the efforts of the Swaziland National Tuberculosis (TB) Control Programme between 2004 and 2014. The objective is to describe the disparity between actual declines in case notification and increases in estimated incidence. The review of policies and practices shows the most influential factors associated with the decrease in TB case notification to be an increase in access to antiretroviral therapy for co-infected TB patients, the general success of TB and human immunodeficiency virus service integration in the country and improvements in implementation of all components of directly observed treatment, active case finding, and rapid diagnosis using new technologies.

Cette étude d'observation rétrospective documente les efforts du programme de lutte contre la tuberculose (TB) du Swaziland entre 2004 et 2014. L'objectif est de décrire la disparité entre un réel déclin dans la déclaration des cas et une augmentation de l'incidence estimée. La revue des politiques et des pratiques montre que les facteurs les plus influents associés au déclin de la déclaration des cas de TB sont liés à une augmentation de l'accès aux antirétroviraux pour les patients tuberculeux co-infectés, au succès d'ensemble de l'intégration des services pour la TB et ceux pour le virus de l'immunodéficience humaine dans le pays et aux améliorations dans la mise en œuvre de tous les composants du traitement sous observation directe, de la recherche active des cas et d'un diagnostic rapide grâce aux techniques nouvelles.

Con el presente análisis observacional retrospectivo se documentan las iniciativas emprendidas por el Programa de Control de la Tuberculosis (TB) de Swazilandia del 2004 al 2014. El objetivo del estudio fue describir la discrepancia existente entre la disminución en la notificación de casos de TB y el aumento en las estimaciones de incidencia de la enfermedad. El análisis de las políticas y las prácticas puso de manifiesto que los factores que más influyen sobre la disminución de la notificación de casos de TB es un aumento en el acceso al tratamiento antirretrovírico por parte de los pacientes coinfectados por el virus de la inmunodeficiencia humana y la TB, el éxito general de la integración de los servicios que se ocupan de ambas enfermedades en el país y los progresos en la aplicación de todos los componentes del tratamiento directamente observado, la búsqueda activa de casos y el diagnóstico rápido mediante nuevas tecnologías.

Keywords: TB case notification; antiretroviral therapy; new and recurrent TB; smear-negative TB.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Estimated TB incidence, notification and notification by TB category, Swaziland, 1995–2013. SM+ = smear-positive; SM− = smear-negative; Unk = unknown; EPTB = extra-pulmonary tuberculosis; TB = tuberculosis.
FIGURE 2
FIGURE 2
Comparison of TB case finding against national ART scale-up, Swaziland, 2001–2013. TB = tuberculosis; ART = antiretroviral therapy; EPTB = extra-pulmonary tuberculosis; PTB = pulmonary tuberculosis.
See this image and copyright information in PMC

References

    1. World Health Organization. Global tuberculosis control, 2014. Geneva, Switzerland: WHO; 2014. WHO/HTM/TB/2014.
    1. Bicego G T, Nkambule R, Peterson I et al. Recent patterns in population-based HIV prevalence in Swaziland. PLOS ONE. 2013;8:e77101. - PMC - PubMed
    1. United Nations in Swaziland. Joint United Nations Programme of support on HIV and AIDS (JUNPS), 2005–2015. Mbabane, Swaziland: UNICEF; 2009.
    1. Ministry of Health. Report of joint external review of the Kingdom of Swaziland National TB Programme, April 2014. Kingdom of Swaziland Ministry of Health; Mbabane, Swaziland: 2015.
    1. Cattamanchi A, Dowdy D W, Davis J L et al. Sensitivity of direct versus concentrated sputum smear microscopy in HIV-infected patients suspected of having pulmonary tuberculosis. BMC Infect Dis. 2009;9:53. - PMC - PubMed