Swaziland continues to be severely burdened by the dual TB-HIV epidemic. Current estimates of TB prevalence are 907/100,000 population, placing the country at the top high burdened countries in the world. The estimated incidence is currently at 733/100,000 and estimated TB-related mortality (excluding HIV) has stabilized at approximately 51/100,000 population over the last decade. The TB/HIV co-infection rate among incident TB cases has remained above 80% and equally challenging is the increasing burden of drug resistant TB cases in the country.
Over the last 5 years, the Ministry of health through the National Control Program has managed to significantly contribute to the steady decline in TB case notification rates. The trends in notification rates over the last 5 years suggest a huge gap in TB case detection, as based on current case notification the detection rate is 60%. In 2015, 4567 new and relapse TB cases were notified, translating to a notification rate of 480 per 100,000 population. This represents a 39% decline from the peak of 1,069 per 100,000 in 2009. While the sustained increase in access to antiretroviral treatment among co-infected TB patients could partly account for this decline, narrow case finding, especially among high-risk populations may be a contributory constraint. Notably, children account for only 10% of notified TB cases.
Dashboard on key performance indicators for TB
CORE TB CASE DETECTION AND MANAGEMENT
1.TB Case detection rate
2. TB Case notification rate
3.Treatment success rate (All forms)
DIAGNOSIS AND LABORATORY (GENEXPERT SMEAR MICROSCOPY AND CRL FOR CULTURE/DST)
4.Percentage of laboratories performing regular external quality assurance
COLLABORATIVE TB/HIV ACTIVITIES
5.Percentage of HIV-positive registered TB patients given antiretroviral therapy during TB treatment
TB INFECTION PREVENTION AND CONTROL (TB IPC)
6.Percentage of health care facilities implementing and adhering to National TB IPC guidelines
-One facility was disaccredited
MULTI-DRUG RESISTANT TB
7.Treatment success rate of MDR-TB
8.Existence of NTCP strategic plan (operational plan. Budget, M&E plan)
9.HR Absorption rate (# of post within government post established and filled).