Ugu District’s antenatal HIV cause for for concern

AT an astounding 41,9 percent, the HIV prevalence in antenatal clients tested in the Ugu District during the last 12 months is the second highest of all the district municipalities in South Africa.

And the Ugu District tuberculosis (TB) incidence of 1 254.2 per 100 000 people, although representing a decrease compared to the last year’s figure, is still the highest in the country.

Ugu Distict also has the highest caesarean section rate in KwaZulu-Natal. At 37.1 percent it is well above the national rate of 20.8 percent, according to the District Health Barometer report, released this week by the Health Systems Trust. The report examines primary health care in South Africa’s 52 district municipalities.

It also looks at health expenditure in each district. In the Ugu District the proportion of district health services expenditure on district management is 1.7 percent, lower than the provincial average of 2.1 percent. Health expenditure on district hospitals, at 40.1 percent, is also below the provincial average, which is 41.9 percent. Primary health care expenditure is 58 percent.

Although the Ugu caesarean section rate is so high, maternal mortality rates have decresed substantially, while stillborn figures remain stable. There is also some good news on the HIV front. In Ugu District, early infant HIV diagnosis coverage is 84.3 percent, well above the national coverage. Immunisation coverage for children under one year is also excellent. At 98.8 percent it is well above the national average of 94 percent.

With diarrhoea still the main cause of infant mortality, Ugu statistics for this condition are a concern. The incidence of children under five years who suffer from dehydration caused by diarrhoea is 16.7 episodes per 1 000 children. This has increased from 14.5 last year and is higher than both the provincial and national averages. Diarrhoea fatalities among the under-fives has increased from 3.4 percent to 4.5 percent.

In the Ugu District, the child under five years pneumonia incidence has decreased from 187.3 cases per 1 000 children last year to 177.9, but this is still well above the national incidence of 66.8. The child under five years pneumonia fatality rate has decreased from 3.3 percent to 1.7 percent. However, the incidence of acute malnutrition in children under five has increased from 5.5 cases per 1 000 children to 7.4 cases per 1 000 children, although fatalities from this condition among the under-fives has decreased from 14.5 percent to 11.3 percent.

As for the TB scourge, 2 237 people in the Ugu District have been diagnosed with this deadly disease during the year. This figure represents a decrease since the previous year when there were 2 897 new cases. The TB rate of of 291.3 per 100 000 people is well above the national incidence of 235.7. The TB cure rate and defaulter rate are both below the national average.