TB/HIV epidemic in the Western CapeUpdate

23 February 2010Nathea Nicolay

Programme Director: Health

“When you want to go fast, you walk alone

When you want to go far, you walk together”

(African proverb)

HIV, AIDS and TB on the continent

Estimated HIV(2010)

Actual TB(2007)

Deaths per day 1 100 210

HIV infections per day 1 400 13 171

People living with HIV/TB 5.8 million 336 000

Total deaths 388 000 76 761

Total new HIV infections 495 000 461 000

Total in need of ART 1.3 million

Total on treatment 900 000 – 1000 000

Source: UNAIDS; Nathea Nicolay from ASSA2003(Provincial) AIDS and Demographic model

Global TB Report 2009, WHO; Mortality and causes of death in SA 2007: Findings of death notifications, Stats SA

12.8% of all causes of death in 2007 due to TB – number 1 cause of death in SA

TB distribution

Source: Global Tuberculosis Control, WHO Report 2009

HIV Infections and AIDS Deaths

Source: Nathea Nicolay from ASSA2003(Full) AIDS and Demographic model

New HIV infections versus AIDS deaths

-

100,000

200,000

300,000

400,000

500,000

600,000

700,000

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

2012

2014

2016

2018

2020

AIDS Deaths Total new infections (in the year starting 1 July)

New HIV infections (Incidence)

Source: Nathea Nicolay from ASSA2003(Provincial) AIDS and Demographic model

Projected HIV prevalance rate

0%2%4%6%8%

10%12%14%16%18%

WC

NW

NC

MP

LP

EC

FS

GT

KZN

HIV Staging

Source: Nathea Nicolay from ASSA2003(Full) AIDS and Demographic model

ASSA2003: Number of HIV positive adults broken down by disease stages

-1,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,000

1995

1997

1999

2001

2003

2005

2007

2009

2011

2013

2015

2017

2019

Year

Pe

op

le

Stage 1: Acute HIV infection Stage 2: Early disease Stage 3: Late disease

Stage 4: AIDS Stage 5: ART Stage 6: Off ART

The Problem: SA Health Care Needs

Sources: 1. Nathea Nicolay from ASSA2003 (Full) AIDS and demographic model 2. Shisana O, Rehle T, 20093. Harrison S, Bhana R, Ntuli A, editors: 20074. Statistics South Africa, 2005: Pretoria.

• HIV, AIDS and TB epidemics:• 5.8 million HIV positive people (1) = biggest HIV epidemic in the world

• TB = leading cause of AIDS related deaths in SA

• HIV prevalence rates: stabilized at 11% (total pop) (2)

• HIV pos women 25 – 29: 33%; HIV pos men 30 – 35: 26% (2)

• Unequal distribution of health care resources: • 85% of SA accessing only 40% of total health care spent (public health);

• 15% of SA accessing 60% of health care spent (3)

• Mortality and life expectancy:• Male death rates: increased by 180% from 1997 to 2004

• Female death rates: increased by 240% from 1997 to 2004 (4)

Multi drug resistant TB – MDR TB

WC relatively low rates of MDR TB vs other provinces 1% of TB patients have MDR TB People who are diagnosed with TB after having been treated

for TB before, 4% will have MDR TB. WHO ranks South Africa the 9th country in the world who

notifies the most number of TB cases every year. On average between 450 and 600 new cases of MDR TB are

diagnosed in the Western Cape annually. HIV pos person more susceptible to TB (not necessarily MDR

TB)

Source: http://www.capegateway.gov.za/eng/pubs/public_info/M/115549

Nathea Nicolay

nnicolay@metropolitanfoundation.org.za

082 786 4677

www.livethefuture.co.za

www.redribbon.co.za

www.metropolitanfoundation.co.za

www.aidsbuzz.org