{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:56:05Z","timestamp":1792594565938,"version":"4.5.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study investigated the associations between socio-economic deprivation and tuberculosis (TB) treatment outcomes, alongside well-known TB risk factors. The effects of healthcare expenditures and their growth on trends in TB incidence from 2009 to 2013 were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Secondary data analysis was performed on data obtained from various sources including governmental, non-governmental and research institutions. Indicators for TB treatment outcomes included TB death rate, TB rate among the household contacts of the Index TB cases, TB treatment failure, HIV associated TB death rate, TB defaulter rate, and new TB smear positive cases. Analysis of variance (ANOVA) and Turkey\u2019s tests for post-hoc analysis were used to compare means of variables of interest considering a type I error rate of 0.05. Regression models and canonical discriminant analysis (CDA) were used to explore the associations between trends in TB incidence and independent TB predictors. During CDA, Fischer\u2019s linear functions, Eigen values, and Mahalanobis distances were determined with values of Wilk\u2019s Lambda closer to zero being the evidence for well discriminated patient groups. Data analysis was performed using SPSS\u00ae statistical software version 23.0 (Chicago, IL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 62 400 records of TB notification were analyzed for the period 2009\u20132013. The average TB incidence rate over a 5-year period was 298 cases per 100,000 inhabitants per year. The incidence of TB was reduced by 79.70% at the end of the evaluation as compared to the baseline data in 2009. Multiple linear regression analysis showed that the Expenditure per patient day equivalent (PDE) and PHC expenditure per capita were significantly and independently associated with the decline of TB incidence (adjusted R\n                      <jats:sup>2<\/jats:sup>\n                      = 60%; \u03c1 = 0.002) following the equation:\n                      <jats:italic>Y = (- 209\u00d7 Expenditure per PDE) + (- 0<\/jats:italic>\n                      .\n                      <jats:italic>191 \u00d7 PHC expenditure per capita)<\/jats:italic>\n                      . CDA showed that in the most socio-economically deprived communities (quintile 1), HIV associated TB death rates were significantly more likely to be higher as compared to the least socio-economically deprived group (quintile 5) [Eigen value (12.95), function coefficient (1.49) &gt; (.77); Wilk\u2019s Lambda = .019, p &lt; .0001].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although TB control programs in OR Tambo district have averted thousands of TB incident cases, their effects on HIV associated TB deaths among the most deprived communities remain insignificant. There is an urgent need for strengthening integration of TB\/HIV services in most deprived settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0264811","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T13:38:31Z","timestamp":1646919511000},"page":"e0264811","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of tuberculosis incidence and the effects of multiple deprivation indices on tuberculosis management in OR Tambo district over a 5-year period"],"prefix":"10.1371","volume":"17","author":[{"given":"Ntandazo","family":"Dlatu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Longo-Mbenza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1329-3864","authenticated-orcid":true,"given":"Teke","family":"Apalata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"pone.0264811.ref001","volume-title":"The Global tuberculosis report 2020.","author":"World Health Organisation","year":"2020"},{"issue":"10","key":"pone.0264811.ref002","doi-asserted-by":"crossref","first-page":"728","DOI":"10.7196\/SAMJ.2019.v109i10.14073","article-title":"Figures of the dead: A decade of tuberculosis mortality registrations in South Africa","volume":"109","author":"M Loveday","year":"2019","journal-title":"SAMJ"},{"key":"pone.0264811.ref003","first-page":"7","article-title":"Risk of Death among HIV co-infected Multidrug Resistant Tuberculosis Patients, Compared to Mortality in the General Population of South Africa.","volume":"3","author":"SO Manda","year":"2013","journal-title":"J AIDS Clin Res"},{"key":"pone.0264811.ref004","doi-asserted-by":"crossref","DOI":"10.1596\/37120","volume-title":"Overcoming the Legacy of Exclusion in South Africa","author":"World Bank","year":"2018"},{"key":"pone.0264811.ref005","volume-title":"The Global Tuberculosis Control.","author":"World Health Organisation","year":"2018"},{"issue":"2","key":"pone.0264811.ref006","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.rppnen.2017.11.003","article-title":"Tuberculoses, social determinants and co-morbidities (including HIV).","volume":"24","author":"R Duarte","year":"2018","journal-title":"Pulmonology"},{"key":"pone.0264811.ref007","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s13012-017-0661-1","article-title":"Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol.","volume":"12","author":"K Naidoo","year":"2017","journal-title":"Implementation Sci"},{"key":"pone.0264811.ref008","volume-title":"South Africa\u2019s National Strategic Plan for HIV, TB and STIs 2017\u20132022.","author":"SA National Department of Health"},{"key":"pone.0264811.ref009","volume-title":"Census 2011 Statistical release\u2013P0301.4.","author":"Statistics South Africa","year":"2012"},{"key":"pone.0264811.ref010","unstructured":"Noble M, Zembe W, Wright G, Avenell D. 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