Boland/Overberg Region Annual Health Status Report 2007/08 Report compiled by Dr René English & The Information Management Office Boland/Overberg Regional Office Worcester BOLAND/OVERBERG REGION ANNUAL HEALTH STATUS REPORTREPORTREPORT 2007/082007/082007/08 Compiled by Dr René English &&& The Information Management Office Boland/Overberg Regional Office WorcesterWorcesterWorcester 3 ForewordForewordForeword This report may be the last in a series of reports which were first published in 2001. In that year, Dr Pam Groenewald was asked to use all the available information from the Information Management Department of the Boland/Overberg office, compile it in an easily readable report, and provide a deeper analysis with recommendations. We were fortunate to get Dr René English involved when Dr Groenewald was no longer available after 6 years. This report targets grassroots health workers, middle management and interested community members. I hope that you, as the reader, will understand the health issues much better and that it will inspire you to do what you can to make things better for the community out there. I want to use the opportunity to thank Dr René English, the final author, Mrs Wilna Van Der Merwe and her Information Management team, the Health Programme staff of the Worcester office, and those in the services who have to collect and manage the data on a daily basis. This is the feedback that we owe you! Dr Frans Krige Director of the Boland/Overberg Region 4 AcknowledgementsAcknowledgements The following people are acknowledged for participation in the compilation of the data and/or in the writing of this report. Dr Frans Krige Mrs Wilna Van Der Merwe Mrs Lizette Basson Mr Enrico Goodman Mrs Marieta Van Niekerk Ms Gladesene Verwey Ms Faeza Champion Mr Tom Karsten Dr Tracey Naledi Dr Astrid Dearham Dr Nazia Peer Staff of the Boland/Overberg District who participated in meetings held at the District Office. Facility staff who collected the data. Dr Lizette Phillips – Director of Cape Winelands since 1 June 2008. Mrs Pam Groenewald – for laying the foundation over the past 6 years. 5 Table of Contents 1. DEMOGRAPHY........................................................................................................................................... 10 1.1 OVERBERG DISTRICT ...............................................................................................................................................12 1.2 CAPE WINELANDS DISTRICT .....................................................................................................................................12 1.3 POPULATION DISTRIBUTION BY LOCAL MUNICIPALITY .....................................................................................................14 1.4 MORTALITY PROFILE...............................................................................................................................................15 1.4.1 Causes of Death.........................................................................................................................................17 1.4.2 Age patterns of death by sex and age group ............................................................................................17 1.4.3 Years of Life Lost (Premature mortality) ...................................................................................................19 1.4.4 Years of Life Lost (all persons)...................................................................................................................19 1.4.5 Years of Life Lost (males and females) ......................................................................................................20 1.4.6 Years of Life Lost (all persons) by local municipality .................................................................................22 1.5 SUMMARY ............................................................................................................................................................24 1.6 RECOMMENDATIONS ..............................................................................................................................................24 2 TUBERCULOSIS ........................................................................................................................................... 26 2.1 TB MONITORING....................................................................................................................................................26 2.2 TREATMENT OUTCOMES..........................................................................................................................................27 2.2.1 Cure Rates .................................................................................................................................................28 2.2.2 Treatment Completed ...............................................................................................................................29 2.2.3 Treatment Success Rates...........................................................................................................................30 2.2.4 Died ...........................................................................................................................................................31 2.2.5 Treatment Failure......................................................................................................................................31 2.2.6 Treatment Interrupted (Defaulted) – new smear-positive ........................................................................31 2.2.7 Transfer Out ..............................................................................................................................................33 2.3 TUBERCULOSIS CASE (CASEFINDING) - 2007................................................................................................................33 2.3.1 Smear Conversion......................................................................................................................................35 2.4 MDR TB..............................................................................................................................................................35 2.5 DISCUSSION ..........................................................................................................................................................36 2.6 RECOMMENDATIONS ..............................................................................................................................................37 3. HIV AND AIDS............................................................................................................................................ 38 3.1 ANTENATAL PREVALENCE.........................................................................................................................................38 3.2 PREVENTION PROGRAMMES.....................................................................................................................................40 3.2.1 Voluntary Counselling and Testing (VCT) ..................................................................................................40 3.2.2 Prevention of Mother-to-Child Transmission of HIV (PMTCT)...................................................................43 3.2.3 PMTCT – Baby Follow-up...........................................................................................................................45 3.3 ANTIRETROVIRAL TREATMENT ..................................................................................................................................47 3.4 SUMMARY ............................................................................................................................................................49 3.5 RECOMMENDATIONS ..............................................................................................................................................49 4. CHILD HEALTH ........................................................................................................................................... 50 4.1 IMMUNIZATION COVERAGE......................................................................................................................................50 6 4.1.1 Recommendations.....................................................................................................................................53 4.2 CHILD MORTALITY..................................................................................................................................................53 4.2.1 Infant mortality .........................................................................................................................................54 4.2.2 Causes of infant mortality .........................................................................................................................58 4.2.3 Under-5 mortality rates.............................................................................................................................59 4.2.4 Causes of death in under-5’s .....................................................................................................................60 4.2.5 SUMMARY .........................................................................................................................................................60 4.2.6 RECOMMENDATIONS ...........................................................................................................................................61