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South Africa’s recent National TB Prevalence Survey estimated a prevalence of 852 (95% CI: 679-1026) per 100,000 population among individuals aged 15 years and older, and a prevalence-to-notification ratio of 1.75, and a male-to-female prevalence of 1.62. These findings suggests that: 1) the health system has been unable to diagnose and treat a large number of individuals with TB, and 2) that men continue to bear a disproportionate burden of TB. Compounding these concerns is the fact that men are less likely to access TB testing or successfully complete TB treatment. In this Grand Rounds talk, Dr. Medina-Marino will share recent findings from two on-going studies – an active case finding study using a portable molecular diagnostic device to test individuals in their home using a novel protocol, and a formative study exploring men’s preferences for a gender responsive intervention to support their engagement and retention in care.

Learning objectives: 

1. To describe the magnitude of people with TB not diagnosed by the mental health system; 

2. To compare specimen types used for diagnosing TB among household contacts of TB index patients; 

3. To appreciate the genered inequities associated with TB; and, 

4. To describe men's needs and wants for an intervention to support their engagement and retention in TB care and treatment. 


Dr. Andrew Medina-Marino is a Senior Investigator at the Desmond Tutu Health Foundation (DTHF) in South Africa and co-Leads the DTHF Division of Men’s Health. He is an Honorary Associate Professor in the Department of Medicine, University of Cape Town, an Adjunct Associate Professor in the Department of Psychiatry in the Perelman School of Medicine, University of Pennsylvania, and the South African PI for the University of California Global Health Institute’s Fogarty Fellowship program.

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