Matthys Potgieter, EPCON founder and Science Lead, attended the 7th SA TB conference held in Durban, South Africa, from 13-16 September. A key goal of the conference was to re-energise the TB community, including academic, governmental, non-governmental and civil society stakeholders, to bring TB control back on track following the Covid-19 epidemic.
South Africa ranks amongst the top 30 highest TB burden countries, with an incidence rate of 554 per 100,000, including a high drug-resistant TB incidence (6,800 cases annually), and a high TB/HIV co-infection rate, according to the Global TB Report issued by the WHO in 2021. In addition, TB testing has decreased by 23% from 2019 to 2020 due to Covid-19. Yet, against this concerning backdrop, The Health Foundation’s satellite session at the conference on the Western Cape Provincial Health Data Centre (PHDC) offered some optimistic news.
The Western Cape is one of nine provinces in South Africa, with close to seven million inhabitants, three-fourths of whom use public-sector services. For many high-burden health conditions such as HIV or TB, the vast majority of patients use the public sector for all or most of their care. The PHDC utilises a tool for linking a patient’s data, regardless of the public hospital or clinic visited, on a central web interface. By combining patient data from different sources, the PHDC allows for interoperability and flexibility within a diverse South African context. Clinical decision making is significantly improved. Should a patient visit a different health institution, the patient’s medical records and history are automatically available to inform treatment decisions.
Further benefits of the Western Cape’s PHDC include the linkage of a call centre to the database, so that in the event of a positive TB diagnosis, a patient can be contacted to attend a nearby clinic. Patients often need to be contacted via SMS or in the evenings or on weekends to ensure availability. Further, data from the PHDC can also be automatically aggregated for reporting and analytics - for example, relating to data on the number of positive TB patients within a particular time frame, or on a new risk factor.
A potential limitation involves the necessity of a change management process both to ensure that relevant stakeholders are trained to use these new tools, and to make certain that the source data is entered correctly. With suitable training and the right technology, the single consolidated environment for person-level health data in the Western Cape has led to major benefits for the care of patients with TB, and is a good example of the use of digital technologies in the fight against TB.