The role of socio-economic factors for the risk of developing TB is unclear. Differences and similarities between cases and controls on various socio-economic factors were determined. Some 84 black TB patients on ambulatory treatment and 84 disease free controls living in the same urban area (South Africa) and matched for age and sex were studied. Variables measured were demographic details, general living conditions, household ownership of luxury items and, weekly consumption of four proteins (meat, fish, chicken & cheese). Three socio-economic indices were constructed from the above variables. No significant differences were found between cases and controls on most of the variables. Overall, significant differences were found on the pattern of language groups (chi-square; p= 0.031) employment groups (chi-square; p= 0.029) and meat (chi-square; p= 0.012) and chicken consumption (chi-square; p=0.034). A tendency was observed for more employed cases than controls to have a primary school education. However, no conclusive evidence was found on the association between socio-economic factors and risk of developing TB. The development of a more appropriate socio-economic measure for developing countries is a necessary step for further research.

A voluntary health worker project (Operation Elsies River) was started in a high incidence TB area in the Western Cape of South Africa, in order to assist the local TB control programme with case-holding. The objective is to evaluate the effectiveness of this group of volunteers in enhancing adherence of notified TB patients to TB treatment. A cohort study was conducted with 351 TB patients (203 children and 148 adults). The data from the child and the adult groups were analysed separately. The child group was more adherent to TB treatment than adults. The supervision option with staff dedicated to the treatment of TB, such as the clinic and the SANTA creche, achieved better adherence results for pre-school children. The supervision modalities for adults did not differ in their adherence performance even following adjustment for confounders.

The supervision option provided by the volunteers did not significantly improve the adherence of adult patients to anti-TB treatment.

The setting is a voluntary health worker programme, in the Western Cape South Africa, utilizing volunteers to administer directly observed therapy to TB patients. This study describes the perceptions of health team members regarding the voluntary community health worker project. A qualitative, participatory research study utilizing focus groups.

TB was perceived by the health team to be a stigmatized disease causing some patients to be reluctant to be associated with the TB control programme. Despite the project’s dedicated approach to case-holding volunteers expressed the need to develop skills in providing more comprehensive care. The volunteers appear to administer a more personalized service to TB patients and can bridge the gap between TB patients and the health agency. Sustained evaluation and support seem to be a vital tool in integrating a volunteer project into a health team approach. Its effectiveness appears to depend to a large degree on the people involved.

The setting is a voluntary health worker programme, in the Western Cape South Africa, utilizing volunteers to administer DOT to TB patients. This study describes the perceptions of health team members regarding the voluntary community health worker project. A qualitative, participatory research study utilizing focus groups. TB was perceived by the health team to be a stigmatized disease causing some patients to be reluctant to be associated with the TB control programme. Despite the project’s dedicated approach to case-holding volunteers expressed the need to develop skills in providing more comprehensive care. The volunteers appear to administer a more personalized service to TB patients and can bridge the gap between TB patients and the health agency. Sustained evaluation and support seem to be a vital tool in integrating a volunteer project into a health team approach. Its effectiveness appears to depend to a large degree on the people involved.