Factors Affecting the Spread of Tuberculosis in South Africa

Zoe McLaren, University of Michigan
Nicola Branson, University of Cape Town
William T. Story, University of Michigan
Diego Iturralde, Statistics South Africa

Significant gains have been achieved in reducing AIDS mortality rates but the growing tuberculosis epidemic threatens to erode this progress. This study examines the relationship between poverty, AIDS treatment access and tuberculosis prevalence in South Africa. We use three years of tuberculosis test result data from the National Health Laboratory Service, which includes the majority of tuberculosis tests conducted nationwide. The rich data set includes patient demographic information, detailed test results and clinic location. Using geographic information we link these tuberculosis results to data from the South Africa Labour Force Survey as well as data on the rollout of publicly-provided AIDS treatment. In an event-study framework, we use exogenous variation induced by the rollout of ART to identify the causal impact of AIDS treatment on tuberculosis rates. This project exploits a wealth of medical and geographic data to inform health policy on tuberculosis and HIV in developed and developing countries.