In this study, initial tuberculosis (TB) default was measured in clinics in a district with a high incidence of TB. A retrospective
review of TB case identification registers in 2007 found 4049 (9.0%) new smear positive pulmonary tuberculosis (PTB) cases from
44 987 suspects. There were 725 (17.9%) initial defaulters. Fifty-three percent of those traced had already died. TB is the leading
cause of death in South Africa due to an infectious disease, and the high level of initial defaults in PTB is one of the “unresolved
issues” in TB control programmes that needs to be addressed.