![]() ![]() 1, 7 Coverage using the World Health Organization (WHO) directly observed treatment, short–course (DOTS) strategy is 100% and case detection rates have remained above target since 2003. This marked deterioration of TB control in South Africa over the past two decades of increasing HIV prevalence has occurred despite reported progress towards National TB control programme case management targets. 3 - 5 Fuelled by high HIV prevalence, TB notifications are now most frequent between the ages of 20 years and 40 years. Here TB annual notification rates were reported to exceed 1500/100,000 in 2006. ![]() 2 The distribution of TB cases within this population, however, is very unequal, with unprecedentedly high burdens in the crowded and socially deprived African townships. Total TB notifications in Cape Town, a city of 3.2 million people, reached 27,000 in 2006. An estimated 73% of these cases were co-infected with HIV, and South Africa alone accounted for approximately 25% of the global burden of HIV-associated TB. ![]() 1 A total of 461,000 new cases of TB in 2007 reflected the one of the highest national TB notification rates in the world (948/100,000 population). South African tuberculosis (TB) notifications have increased 6-fold over the last two decades, largely as a result of increasing HIV prevalence. ![]()
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