South Africa: Western Cape Launches Public Facing TB Dashboard to Help Monitor TB Responses

press release

Western Cape Government launches first-of-a-kind public facing TB dashboard to help monitor the province's TB response

I am pleased to announce today that the Western Cape Government has launched the first-of-a-kind public facing Tuberculosis (TB) dashboard. The TB dashboard will assist in monitoring the implementation of the Province's Multisectoral TB response plan.

This follows my commitment in my State of the Province Address that we must treat the TB epidemic with the same seriousness as we have in the fight against COVID-19. I also pledged to use the lessons learnt from our agile COVID-19 response in the fight against TB. The provision of up-to-date public data that enables behaviour change and monitors the success of government interventions is a key part of this.

The TB response plan was formed and approved by the Provincial Council on Aids and TB (PCAT), which I chair, to address the serious impact that COVID-19 has had on TB-related testing, diagnosis and treatment in the province.

The TB response plan, through the use of this interactive TB dashboard, aims to get our TB response back on track, promote transparency and digitise our response. TB has long been an epidemic in the Western Cape and the dashboard will assist us in collating real-time data to respond effectively.

The TB dashboard is modelled on the COVID-19 dashboard and includes data on TB cases, deaths, tests, test positivity and drug resistance, from 2015 onwards. These are aggregated and updated monthly to ensure that clinical and laboratory data are representative of the included period.

A number of headline (top centre) data elements are reported for a selected date range (automatically set to the previous year). These include:

TB Tests (GXP): The total number of first-line GeneXpert (GXP) tests done in the provincial public sector to screen for TB or confirm a TB diagnosis.

Percentage Positivity: This refers to the proportion of all GeneXpert tests for the given selected period which were positive, reflected as a percentage.

Number of TB cases in the Western Cape: The total number of diagnosed TB cases in the province, whether through laboratory tests, X-rays and/or clinically by a healthcare practitioner.

TB cases in the previous month: This is the total number of TB cases diagnosed, by any means, in the final calendar month of the given date period.

Number of TB Deaths: This is the total number of deaths that have been associated with TB in the Western Cape for the given date range (date of death in the date range).

Additional components of the dashboard include:

Geographic breakdown of cases or positivity: Based on the location of diagnosis, the number of cases or proportion positivity amongst GXP tests, is reflected for the selected date range by subdistrict. These can be rapidly filtered to rural or metro subdistricts and reflect as horizontal bar graphs (left) and a shaded map (centre).

Temporal trends in cases, deaths, GXP tests and test positivity. The graphs on the right show changes over time in these core metrics. The deaths are reflected on the same graph as the cases to allow comparison of the ratio of new cases diagnosed to deaths in the same period. Test positivity is reflected on the same graph as the total number of GXP tests done.

A separate set of graphs detail drug-resistant TB (DR-TB), a subset of the total TB burden. These graphs are the same as for all TB, with the exception that the testing is reflected as the proportion of all positive GeneXpert tests which had drug-resistance (to rifampicin, a key frits-line TB antibiotic) identified.

Finally, there is an option for users to conduct a TB screening questionnaire through a link to a WhatsApp service.

According to the dashboard, the status of the TB epidemic in the Western Cape is as follows:

The total number of TB cases diagnosed between 1 September 2020 and 31 August 2021 was 38 846 with 1578 (4.1%) of these being drug-resistant;

3041 cases were diagnosed in the last calendar month of the period, or August 2021;

The total number of confirmed deaths associated with TB in the previous year was 4078; and

In total, 186 097 GXP tests were conducted in the previous year, with 17% being positive, and 4.2% of these showing drug resistance.

I encourage residents to familiarise themselves with TB symptoms to play their part in stopping the spread and getting help from our health department as soon as possible.

The most common symptoms of TB include:

A persistent or unexplained cough.

Bloody sputum or phlegm.

Pain in your chest when coughing or breathing.

Weight loss and/or loss of appetite. Or inadequate growth in children (not gaining weight as expected).

Malaise or fever.

Sweating profusely at night.

TB disease can affect any part of the body, so please ask your healthcare worker to consider it if you have any unexplained health symptoms or problems.

People who had close contact, possibly at home, work or school, with somebody who was diagnosed with TB disease, are at increased risk of becoming infected and ill themselves. TB is spread through the air like COVID-19. TB disease has unfortunately been a source of unfair stigma and discrimination. Anybody can become ill with TB, through no fault of their own.

If you think that you or one of your loved ones may have TB, you should immediately consult a healthcare practitioner, who can conduct a clinical assessment, send away sputum for testing and possibly refer you for further x-ray testing. You can also use the screening function available on the TB dashboard for additional guidance. If you had close exposure to TB, please also talk to your healthcare provider, who will screen and test you, and may offer you TB preventive therapy which includes antibiotics to prevent you from becoming ill with TB.

Both TB and COVID-19 can present in very similar ways, so your healthcare provider may consider both diseases when you are ill and go for testing. Both also require the same infection control measures including good airflow or ventilation, masks, distancing and the need to isolate until you are no longer infectious. TB is completely curable, even the drug-resistant types, if it is diagnosed quickly enough and the person is adequately supported to complete his or her treatment.

I want to commend the Provincial Minister of Health, Dr Nomafrench Mbombo, the Provincial Department of Health's data scientists, as well as PCAT on the launch of the TB dashboard. We are extremely proud of their hard work which will go a long way in helping us to save lives.

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