ArticleThe Journal of infectious diseases2017
The South African Tuberculosis Care Cascade: Estimated Losses and Methodological Challenges.
Article in The Journal of infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04298905 (Leveraging mHealth to Enable and Adapt Community Health Worker Strategies to Improve TB/HIV Patient Outcomes in South Africa), which is not on this map. Cited by 163 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Leveraging mHealth to Enable and Adapt Community Health Worker Strategies to Improve TB/HIV Patient Outcomes in South Africa (LEAP-TB-SA) Trial
Who cites it
163 citing papers in PubMed, 6 syntheses or guidelines pooled it, 252 citations in OpenAlex.
- Implementation strategies to increase the uptake and impact of molecular WHO-recommended rapid diagnostic tests: evidence from a mixed-methods systematic review.BMJ global health · 2025Pooled it
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Development of treatment-decision algorithms for children evaluated for pulmonary tuberculosis: an individual participant data meta-analysis.The Lancet. Child & adolescent health · 2023Pooled it
- Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review.PloS one · 2021Pooled it
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Spatially targeted screening to reduce tuberculosis transmission in high-incidence settings.The Lancet. Infectious diseases · 2019Pooled it
- Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa.Journal of substance use and addiction treatment · 2025Trial
- Household Contact Tracing With Intensified Tuberculosis and Human Immunodeficiency Virus Screening in South Africa: A Cluster-Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Treatment initiation among tuberculosis patients: the role of short message service (SMS) technology and Ward-based outreach teams (WBOTs).BMC public health · 2022Trial
- A cluster-randomized controlled trial to improve the quality of integrated HIV-tuberculosis services in primary healthcareclinics in South Africa.Journal of the International AIDS Society · 2021Trial
- SMS nudges as a tool to reduce tuberculosis treatment delay and pretreatment loss to follow-up. A randomized controlled trial.PloS one · 2019Trial
- Cost-effectiveness of universal isoniazid preventive therapy among HIV-infected pregnant women in South Africa.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2018Trial
- Closing gaps through innovation in the tuberculosis pathology value chain.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Review
- Developing an integrated medication event monitoring system and smartphone-based ecological momentary assessment delivery platform to identify real-time factors influencing TB treatment adherence in South Africa.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Article
- Investigating Gendered Implicit Bias Among Healthcare Workers in South Africa: Development and Piloting of an Implicit Association Test in a High Tuberculosis and HIV Setting.Research square · 2026Article
- Article
- Potential long-acting tuberculosis treatment for people with HIV: cost-effectiveness benchmarks.Annals of the American Thoracic Society · 2026Article
- A historical budget impact and expenditure analysis of meropenem and clavulanate-based treatment for adults with XDR-TB at a specialised TB hospital in South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Time to treatment initiation in pregnant women with tuberculosis in Cape Town, South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Estimating the number of incorrect tuberculosis diagnoses in low- and middle-income countries.Nature medicine · 2026Article
103 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: While tuberculosis incidence and mortality are declining in South Africa, meeting the goals of the End TB Strategy requires an invigorated programmatic response informed by accurate data. Enumerating the losses at each step in the care cascade enables appropriate targeting of interventions and resources. Methods: We estimated the tuberculosis burden; the number and proportion of individuals with tuberculosis who accessed tests, had tuberculosis diagnosed, initiated treatment, and successfully completed treatment for all tuberculosis cases, for those with drug-susceptible tuberculosis (including human immunodeficiency virus (HIV)-coinfected cases) and rifampicin-resistant tuberculosis. Estimates were derived from national electronic tuberculosis register data, laboratory data, and published studies. Results: The overall tuberculosis burden was estimated to be 532005 cases (range, 333760-764480 cases), with successful completion of treatment in 53% of cases. Losses occurred at multiple steps: 5% at test access, 13% at diagnosis, 12% at treatment initiation, and 17% at successful treatment completion. Overall losses were similar among all drug-susceptible cases and those with HIV coinfection (54% and 52%, respectively, successfully completed treatment). Losses were substantially higher among rifampicin- resistant cases, with only 22% successfully completing treatment. Conclusion: Although the vast majority of individuals with tuberculosis engaged the public health system, just over half were successfully treated. Urgent efforts are required to improve implementation of existing policies and protocols to close gaps in tuberculosis diagnosis, treatment initiation, and successful treatment completion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.