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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.100 n.1 Pretoria Jan. 2010




Questionable questionnaire



Petrus van Staden

Empangeni, KwaZulu-Natal,



To the Editor: Question 8 of November 2009's SAMJ CPD reads as follows: 'Many new cases of tuberculosis are infected with multiple drug-resistant organisms.' True or false?

While I admit that any new TB case in South Africa is regrettable, and that we have to adapt our treatment regimen to accommodate the sad fact of MDR-TB, I would not call 1.8% of new TB cases 'many'; in effect, that is quite a small number, statistically speaking. Would you describe a salary increase of 1.8% as large? Or call it a very small increase?

According to the Global Alliance for TB Drug Development (, 'The WHO estimates that MDR-TB makes up greater than 10 percent of all new TB cases in Eastern Europe, the region most affected by the disease. Rates of up to six percent have been reported in many countries.'

Aha! Six to 10% seems to be 'many', so 1.8% is still a few – relatively speaking.

In addition, at 'According to the study, about 25% of all new TB cases in China and about 50% of all previously treated cases are resistant to at least one TB drug.'

Now 25% – that really is many – puts South Africa's 1.8% to shame, doesn't it?

To conclude: 'Few' and 'many' are relative and subjective terms, and I believe that subjectively termed questions should not appear in CPD questionnaires, as the former do not necessarily have hard and fast answers which can't be debated.

We stand corrected! – Editor

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