‘Tuberculosis over the last century’ – public talk, Cape Town

Apr 07, 2015 No Comments by

On 15th April, Robin Wood FRSSAf, Professor of Medicine and Director of Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine at University of Cape Town will present a free public talk entitled “Tuberculosis over the last century. A tale of three cities”.

Abstract: Cape Town has one of the highest TB burdens of any city in the world. In 1900 the City of Cape Town, New York City (NYC) and London were thriving ports with high mortality from tuberculosis (TB). Throughout the 20th century contemporaneous public health measures including screening, diagnosis and treatment were implemented in all three settings. Mandatory notification of TB and vital status enables comparison of disease burden trajectories in each of these cities.

Pre-chemotherapy, TB mortality and notification rates declined steadily in NYC and London but remained high in Cape Town. Following introduction of chemotherapy the mean annual case-fatality dropped from 45-60% to below 10% in all three settings. Mortality and notification rates subsequently declined, although Cape Town notifications returned to pre-chemotherapy levels by 1980. The proportional contribution of childhood TB diminished in NYC and London but remained high in Cape Town. The advent of an HIV-epidemic in the 1990’s was associated with a further two-fold increase in incidence. Notification rates among HIV-negatives remain at pre-chemotherapy levels.

TB control was achieved in both NYC and London but failed in Cape Town. The TB disease burden trajectories started diverging before the availability of chemotherapy in 1950 and further diverged following the HIV epidemic in 1990.  TB treatment impacted case-fatality but did not reduce transmission, evidenced by on-going high childhood TB rates. Currently endemic TB results from high on-going transmission, which is exacerbated by the HIV epidemic. TB control will require reducing transmission, which is inexorably linked to prevailing environmental and socio-economic factors.

All talks are free and held at 5pm at the South African Astronomical Observatory (SAAO) Auditorium, Observatory Road, Observatory*

*Directions to SAAO Auditorium : From the N2, turn off to the M57 – Liesbeek Parkway; turning in the direction of Cape Town and continue until the traffic lights with Hartleyvale (hockey and football) on your left. Turn right at traffic lights into Observatory Road, pass the River Club; the S A Astronomical Observatory is next on the left. Once through the security gates bear left following the SALT signs to the auditorium i.e. last building on the left (white with stoep & ramp).

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