Tuberculosis in the Western Cape health region of South Africa.

Tuberculosis (TB) is a major health problem in the Western Cape health region of South Africa. The incidence rate (based on notifications) is rising (particularly in coloureds) and the annual risk of infection is static in the highest risk group. Risk factors for infection, particularly as a result of overcrowding, and the number of infectious cases in the community are leading to an increase in the infectious pool. Potential risk factors for TB disease such as poor nutritional status, alcoholism, and unemployment are being exacerbated by the current political instability in the country. Poor patient compliance and several health service impediments have resulted in a large number of patients not being held on treatment until cure. There is a need to recognise that non-medical interventions are the key to a future successful TB control programme.