Epidemiological trends and treatment outcomes of tuberculosis patients in rural clinics in Vhembe District, South Africa: A secondary data analysis

Abstract

Background. Tuberculosis (TB) remains a significant cause of morbidity and mortality globally, with the burden disproportionately affecting resource-limited settings. In South Africa’s Vhembe District, there is limited recent evidence on trends in TB burden and treatment outcomes. Objective. To describe TB patterns between 2018 and 2023 by examining demographic and clinical distributions and assessing treatment success as a measure of programme performance. Methods. A retrospective descriptive study was conducted using electronic medical records from six primary healthcare clinics. Data extracted from the Health Patient Registration System included age, sex, HIV status and treatment outcomes. Analyses covered annual TB prevalence, demographic and clinical profiles, and treatment outcomes, including treatment success, mortality, loss to follow-up and transfer out. Treatment success was calculated using only evaluated cases, excluding those transferred out. Results. A total of 562 TB cases were recorded over the study period. Males accounted for 57.7% of cases, and individuals aged 36 - 60 years represented the largest age group (55.3%). HIV co-infection was documented in 48.8% of patients. Among evaluated cases, the treatment success rate was 85.3%, while 9.4% died, 5.1% were lost to follow-up and 0.2% experienced treatment failure. A further 9.3% of patients were transferred out and therefore not evaluated, which limits the accuracy of assessing actual treatment outcomes. The absence of a functional tracking system across clinics further hindered the determination of whether transferred patients completed treatment elsewhere. Conclusion. Although treatment success among evaluated cases approached the World Health Organization target, the persistent TB burden and substantial proportion of unevaluated cases highlight systemic gaps in treatment continuity and monitoring in Vhembe District. Strengthening patient-tracking mechanisms, enhancing adherence support and improving integration of TB-HIV services are critical for advancing progress towards End TB goals.