In Practice

Figures of the dead: A decade of tuberculosis mortality registrations in South Africa

M Loveday, Y N Mzobe, Y Pillay, P Barron


South Africa (SA) is committed to reducing tuberculosis (TB) mortality rates in line with the World Health Organization’s End TB Strategy and the Sustainable Development Goal (SDG) targets. From mortality reports released by Statistics South Africa, this study analysed reported TB mortality in SA from 2006 to 2016 to inform our understanding of TB mortality and the development of strategies needed to attain the SDG targets. TB mortality includes all deaths reported to the Department of Home Affairs with TB reported as the underlying cause of death based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) definition. Although TB remains the leading cause of death, TB mortality rates in SA have fallen substantially in the past decade. From 2006 to 2016, the number of deaths due to TB plummeted from 76 881 to 29 399 and the proportion of all-cause mortality due to TB more than halved from 13% to <6%. Furthermore, the profile of people dying from TB has changed, with a decrease in the proportion of children aged <15 years, adults of reproductive age (15 - 49) and women, and an increase in the proportion aged ≥50. This change has largely mirrored the overall pattern of deaths in SA, with large decreases in deaths in adults aged 15 - 49, especially women, thought to be because of the scale-up of the antiretroviral treatment programme for HIV. The End TB Strategy target of a 95% reduction in TB mortality by 2035 is achievable in SA. However, sustained effort in high-risk groups together with improved vital registration data are needed to ensure attainment of the target.

Authors' affiliations

M Loveday, Health Systems Research Unit, South African Medical Research Council, Durban, KwaZulu-Natal, South Africa; Centre for the AIDS Programme of Research in South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa

Y N Mzobe, Health Systems Research Unit, South African Medical Research Council, Durban, KwaZulu-Natal, South Africa

Y Pillay, National Department of Health, Pretoria, South Africa

P Barron, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Tuberculosis; Mortality; South Africa

Cite this article

South African Medical Journal 2019;109(10):728-732. DOI:10.7196/SAMJ.2019.v109i10.14073

Article History

Date submitted: 2019-09-30
Date published: 2019-09-30

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