SAHR 2007 - Health Systems Trust

Infectious Disease
Data on syphilis prevalence in antenatal clients are obtained
from the annual antenatal surveys. Data from the 2005
annual survey were published for the WC in a far more
disaggregated manner [Antenatal Survey 2005 WC]. In
addition, the HIV data were published in the South African
Medical Journal in June 2006 [SAMJ 96(538-43)]. As Table 13
shows, the provincial average masked considerable differences
in syphilis prevalence within the province. Prevalence
in the Central Karoo and West Coast districts were more
than twice the provincial average, while the Cape Town
metropole showed below-average rates. This survey represented
the fifth such attempt in this province. Importantly, this
required that all 400 facilities providing antenatal services
be included in the sample. In essence, this required 25 separate
cross-sectional surveys. A sample size was determined
for each area, and then allocated proportionately to each
facility on the basis of the number of first-time antenatal clinic
visits.
Data on syphilis prevalence are also available from the
District Health Information System however, because testing
coverage varies quite a bit between provinces, data quality
may still be a significant reason for the lack of agreement
between the data sources.
No new data on notifiable diseases (such as malaria, cholera,
rabies and tetanus) are available from NDoH, and the information
management system is still being implemented.
Table 13: Syphilis prevalence by district in the WC, 2005
Syphilis prevalence rate (%) (antenatal)
Cape Town DC1 DC2 DC3 DC4 DC5 WC
2005 3.3 8.8 5.4 3.8 6.3 10.6 4.0
Cape Town: City of Cape Town DC1: West Coast District Municipality DC2: Cape Winelands (Boland) District Municipality DC3: Overberg District Municipality DC4: Eden District
Municipality DC5: Central Karoo District Municipality WC: Western Cape
Source:
Antenatal Survey 2005 WC.
Table 14: Syphilis prevalence by province
EC FS GP KZN LP MP NC NW WC SA
Syphilis prevalence rate (%) (antenatal)
1998 9.6 4.4 3.8 15.8 5.6 8.6 3.8 9.1 4.4 10.8 a
1999 4.4 15.8 9.6 3.8 8.6 9.7 3.8 5.6 4.4 7.3 a
2000 3.3 4.8 9.6 2.6 4.2 3.7 5.1 3.6 5.2 4.9 a
2001 3.3 2.0 2.7 1.3 4.9 2.0 6.2 4.0 2.9 2.8 b
2002 3.1 5.0 6.0 1.5 1.9 2.5 5.2 3.2 2.0 3.2 b
2003 3.8 3.8 2.1 1.4 1.7 1.8 8.6 2.0 5.5 2.7 b
2004 2.4 3.8 0.9 0.8 0.9 1.3 7.0 2.1 1.6 1.6 b
2005 2.5 3.0 4.3 1.2 1.1 2.9 8.5 1.9 4.0 2.7 b
2006 2.6 2.5 2.3 1.0 0.6 1.1 6.9 1.8 1.9 1.8 b
2006 DHIS 12.9 4.2 4.0 4.9 2.2 3.3 6.7 11.9 8.5 4.6 c
a DoH Notification System. Data from the annual antenatal surveys.
b Antenatal Survey 2001-2006.
c DHIS. For the DHIS data, approximately two-thirds of antenatal clients
were tested for syphilis overall, substantially more than in previous
years, although there is quite a lot of variation between provinces in the
coverage. Data for 2006 extracted July 2007.
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