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Free Content Tuberculosis surveillance in Cape Town, South Africa: an evaluation

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SETTING: Cape Town, South Africa.

OBJECTIVE: To evaluate the current system of tuberculosis surveillance in the Cape Metro region.

DESIGN: This evaluation was based on the ‘Updated Guidelines for Evaluating Public Health Surveillance Systems’ of the Centers for Disease Control and Prevention, modified to render the framework applicable to the context of tuberculosis (TB) surveillance. The evaluation incorporated qualitative exploration of perceptions and experiences of system users.

RESULTS: System users were very accepting of the system and were committed to seeing it achieve its purpose within public health. Some individuals expressed concerns about the rigidity of the Electronic TB Register software and its analysis capabilities. Dissemination of TB data and evidence-based action within the Cape Metro region are strong attributes of Cape Town's TB surveillance system. At the time of the evaluation, integration of TB and human immunodeficiency virus (HIV) data was weak, as was multidrug-resistant TB (MDR-TB) surveillance; the South African Tuberculosis Control Programme is developing initiatives to improve these areas.

CONCLUSIONS: Cape Metro's TB surveillance is strong, although it would be strengthened by increasing availability of data reflecting TB-HIV co-infection and MDR-TB. Systems operations could be improved by increasing software flexibility, and increased integration of electronic data across health regions would enhance the capacity and assessment of control efforts.
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Keywords: epidemiology; evaluation study; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada 2: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada 3: Department of Medicine, University of Cape Town, Cape Town, South Africa

Publication date: 01 July 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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