The South African National Tuberculosis Association (SANTA) is a non-profit, volunteer community-based organisation (registration no. 000-934-NPO). It was founded in Durban in 1947 by a group of organisations that were involved in anti-TB initiatives. Our vision is straightforward: we strive for ‘A TB-Free Community’. Our mission states that ‘SANTA, as a dynamic, community-based, voluntary association, is committed to serving communities and TB patients throughout South Africa by providing preventative, curative and rehabilitative services in partnership with other stakeholders’.

Today SANTA works in all nine provinces of South Africa, utilising a provincial branch structure and an extensive network of volunteers. We concentrate our efforts in three main areas:

• Publicity, awareness and TB education all over South Africa
• Supporting the Directly Observed Treatment Short-course (DOTS) strategy
• Providing short-term relief to TB patients and their dependents through social assistance projects (e.g. food parcels, soup kitchens, provision of clothing, etc).

Recognising the importance of nutrition

Part of this short-term relief is also about understanding the direct implications of poor nutrition in TB patients, and addressing this problem. We believe that good nutrition can assist in delaying both HIV infection and active TB infection by helping to build stronger immune systems.

It is for this reason that SANTA has been involved in the distribution of e’Pap, a pre-cooked cereal made from maize and soya and fortified with 28 nutrients; e’Pap is an affordable nutritional supplement available all over the African continent, which helps to provide energy and support the immune system. While there is already anecdotal evidence to endorse the positive effects of e’Pap in TB patients, there is a lack of solid statistical evidence to assess the direct influence of such supplements in improving nutritional status over time.

A Pilot Nutritional Research Project

SANTA has recently formed a partnership with the University of the Witwatersrand (Wits) in order to carry out an objective pilot Nutritional Research Project that will examine the impact of a nutritional supplement (in this case, e’Pap) on two population groups: adult TB patients and children.

This research project is an exciting example of what can be achieved through innovative partnerships between different organisations, and has helped to strengthen relationships between the partner organisations involved, including national, regional and local government departments, universities, private sector companies and humanitarian organisations.

The project is being supported/funded by The Society of St. Vincent de Paul, a UK-based NGO, Health Empowerment Through Nutrition (HETN), as well as South African-based organisations BHP Billiton and Econocom Foods (who manufacture the nutritional supplement).

This pilot study will take place in a prominent South African township, Alexandra (referred to by locals as ‘Alex’). Alex is part of wider Johannesburg and is one of the poorest urban areas in South Africa; as part of the Alexandra Renewal Project (launched in 2000) much needed housing has been built to accommodate the growing number of residents, but this increasing population also means that there is pressure on health services and consequently, diseases like TB are rife.

The study

To date, 100 adult TB patients have been enrolled from Alexandra clinics and 67 children (aged 3-6 years) from local crèches to take part in the project. The study is due to take place over a period of approximately three months; the first baseline data collection took place in the week commencing 20th September and subsequent collections will take place at regular intervals until December.

The Health Promotion Unit at the Wits School of Public Health has designed the research procedure, which involves carrying out a number of tests to assess the nutritional health of these participants during the three month period. The following data will be collected:

• Anthropometric measurements, i.e. height, weight, waist/ hip circumference and skinfold thickness
• Clinical indicators, i.e. the condition of the patients’ hair, eyes, nose, skin and nails
• Functional indicators, i.e. hand grip strength, skin elasticity and BIA (Bioelectrical Impedance Analysis)
• Blood tests and an oral health analysis - conducted by medical professionals
• In addition to these tests, participants will also complete surveys which ask them about household food security, i.e. whether they have enough food in their household, the regularity of meals and the types of food they eat (based on recent food consumption).

The nutritional supplement is being given to adult and child participants from baseline data collection onwards, so that the effects of the supplement can be monitored at an early stage.

Progress so far & funding challenges

A supporting Ethics Submission was approved earlier this year, and the project has been endorsed by the Provincial and Johannesburg City Departments of Health, who have provided valuable assistance in enrolling TB patients from local clinics.

The research has already yielded valuable insights into the logistical and organisational complexities of conducting research in a dynamic community environment. It has also established valuable skills which will enable SANTA to include nutritional state assessments in their standard patient monitoring and support activities.

This is a pilot study which, in addition to measuring impacts of the supplement, intends to establish the effectiveness of measuring instruments and processes. We hope that it will pave the way to subsequent, more rigorous research with a larger study population, as well as opening new funding channels.

Additional funding is currently being sought to complete the current phase of research and to plan and initiate a subsequent, more comprehensive study which will implement those research procedures which prove to be most effective (based on the findings of this pilot study).

Find out more...

Results of the study will be shared once the research is complete. In the meantime, if you would like to support this project or find out more please contact us:

Morongwa Magongoa - CEO, SANTA National

Tel: +27 (0)11 454 0260 / Email This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Alison Manuell - Research & Marketing Officer, SANTA National

Tel: as above / Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it