![]() ![]() Non-XDR patients can be admitted to the ward for other TB disease, and risk superinfection/nosocomial infection. Subscripts “c” and “h” refer to the community and hospital environments, respectively (separated by a dotted vertical line). The KwaZulu-Natal province has reported the highest number of cases to date. ( A) Reported XDR TB cases in South Africa, by province, from January 2004 to March 2007. ![]() ![]() Using branching process mathematics, we observed that early, community-based drug-susceptibility testing and effective XDR therapy could help curtail ongoing transmission and reduce the probability of XDR TB epidemics in neighboring territories.īurden and dynamics of XDR TB. In the setting of delayed disease presentation and high system demand, improved diagnostic approaches may need to be employed in community-based programs rather than exclusively at tertiary hospitals. Intensified community-based case finding and therapy appears critical to curtailing transmission. ![]() The effective reproductive number of XDR TB in KwaZulu-Natal may be around 2. We analyzed the transmission dynamics of XDR TB in the region using mathematical models, and observed that nosocomial transmission clusters of XDR TB may emerge into community-based epidemics under the public health conditions of many South African communities. Extensively drug-resistant tuberculosis (XDR TB) has been detected in most provinces of South Africa, particularly in the KwaZulu-Natal province where several hundred cases have been reported since 2004. ![]()
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