A team led by Boston University School of Public Health (BUSPH) researchers has created a near real-time surveillance method to identify communities experiencing a high burden of drug-resistant tuberculosis in South Africa using routinely collected laboratory data.
In the study, published in PLOS Medicine, the researchers mapped the highest rates of drug-resistant tuberculosis in the Western Cape Province and tracked changes over five years. The results will help create a method that can lead to more targeted interventions and public health approaches aimed at reducing the number of people who contract the disease.
“Our model of mapping high-burden communities can serve as a roadmap for regions working to reduce TB incidence by initiating treatment as soon as possible,” says study senior author Dr. Karen Jacobson, assistant professor of epidemiology at BUSPH and assistant professor of medicine in the section of infectious diseases at Boston University School of Medicine. “By locating emerging and chronic hotspots of the disease in real time, public health providers can evaluate the most effective interventions and monitor progress towards TB reduction goals.”
South Africa has the highest rates of tuberculosis (TB) in the world, and 4 percent of these cases are resistant to first line treatment. The country also has a centrally collected laboratory database that includes TB tests, making it an ideal location to implement a surveillance system to track drug-resistant TB cases by clinic location.
The researchers developed an algorithm to identify unique patients and episodes of disease from the data, and created heat maps of the region to see which areas were most afflicted between 2008 and 2013.