Perceptions of Tuberculosis: Attributions of Cause, Suggested Means of Risk Reduction, And Preferred Treatment in the Limpopo Province, South Africa (Report‪)‬

INTRODUCTION South Africa is burdened by one of the worst tuberculosis epidemics in the world, with disease rates more than double those observed in other developing countries and up to 60 times higher than those currently observed in the USA or Western Europe. The Medical Research Council (MRC) estimated that the country had about 180,507 cases (55% reported) in 1997, or 419 per 100,000 of the total population. Of these, 32.8% (73,679 cases) were probably infected with HIV (1). The tuberculosis problem in South Africa is largely a result of historical neglect and poor management systems, compounded by the legacy of fragmented health services. Prior to the introduction of the Tuberculosis Register in 1995, cure rates were unknown, and consequently control efforts could not challenge the poor performance. The implication of this failure is evident from the fact that, in 1997, a cure rate of only 54% could be recorded, with the consequence of continued high rates of transmission in the country (1). Data on self-reported tuberculosis among men and women related more frequently to older people (e.g. age less than 35 years was 1.5% and age more than 35 was 4.6%) and people living in non-urban areas (e.g. men: urban 2.6%, non-urban 3.3%, women: urban 1.6%, non-urban 2.6%) (2).