Strengthening the link between people diagnosed with TB and treatment initiation

In 2021, more than 304,000 (832/day) people in South Africa contracted tuberculosis (TB) and 56,000 (153/ day) died as a result of this preventable and treatable disease. Despite these alarming figures, the country has seen a more than 50% drop in new infections and a nearly two-thirds drop in associated deaths since 2009.

The COVID-19 pandemic exacerbated the TB challenge and had a negative impact on national gains and TB services. The number of TB tests administered nationally decreased by 23% between 2019 and 2020, from 2,076,726 to 1,605,529 tests. The number of patients with laboratory diagnoses declined by 25%, from 207,401 to 155,946. To reverse these losses, the National TB Recovery Plan was created to intensify and accelerate efforts to get back on track to meet the END TB targets.

As part of the plan, on August 8, 2022, the National Health Laboratory Service, with the support of the Centre for TB (National Institute For Communicable Diseases), implemented the automated sending of SMS to people undergoing Xpert laboratory testing for presumptive TB. The service’s success relies heavily on capturing the client’s mobile number. Continuous engagement with both the National Tuberculosis Programme and our laboratory stakeholders has resulted in a gradual increase in the success of this service, from an initial 27% SMS attempted to 42% of those receiving an Xpert test from inception to February 2023, with an average of 79% successfully delivered. Building on the SMS service, the NHLS is currently supporting the e orts of the planned National Health Hotline, which had and currently serves as a direct line to the general public for the Covid-19 service, and had been primarily operated by the NHLS and BPESA, to further support linkage to care and strengthen retention in care by improving contact with clients who have a positive test.

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