TB in spotlight at summit

2015-04-30 16:14

SOUTH AFRICA has the sixth highest occurance of tuberculosis in the world after China and India – almost 1% of the South African population get active tuberculosis every year.

This came to light at the three-day summit held from 17 to 19 March in Durban where stakeholders made far-reaching resolutions to curb the illness. Stakeholders discussed means to optimise the decentralisation of MDR-TB treatment, maximising reporting and advocating efforts to scale up models of care in the fight against drug-resistant TB.

Under the banner of the Lilly MDR-TB partnership, representatives of the national and provincial Departments of Health, various NGOs and healthcare facilities, as well as academics, share best practices and debate the challenges of treating South Africa’s growing burden of multi-drug resistant and extensively drug resistant tuberculosis (MDR-TB and XDR-TB). While the number of TB patients initiated on treatment under the National TB Programme appears to have been decreasing over the last four years, the number of multidrug-resistant TB (MDR-TB) cases is escalating.

“We face many challenges in the fight against MDR-TB. Before approval of decentralised management of the MDR-TB policy, we had several challenges including the fact that nearly half of people diagnosed with MDR-TB would not be started on treatment for various reasons, including months of waiting for admission to treatment facilities and the onerous demands on patients in terms of transport to treatment centres for follow-ups. There was also a significant negative impact on the social and economic status of the individual and family due to the long hospital stay, risk of transmission in hospital due to inadequate implementation of infection control measures, and non-uniformity in the current, sporadic efforts of decentralised management,” said Dr Norbert Ndjeka, head of the National MDR-TB Directorate at the National Department of Health.

Decentralisation of care

Ndjeka said stakeholders were working hard to strengthen the decentralisation of MDR-TB services: “Adding policy implementation is well underway in this regard. Monitoring and evaluation of the facilities and outcomes are critical and various tools are in place to achieve these.

“Our target is to have one MDR-TB treatment initiation (decentralised) site per district by 2016 and to strengthen community MDR-TB care. Last year only 38 districts had at least a MDR-TB treatment site, while 14 districts did not have any form of MDR-TB treatment initiation site. The number of treatment sites had increased from 11 to 63 between 2011 and 2013.

“To date there are 298 MDR-TB treatment initiation sites, 272 satellite sites, 150 injection teams and five Nurse-initiated MDR-TB sites countrywide. Only two districts do not have a MDR-TB treatment initiation site,” said Ndjeka.

“Drug-susceptible TB is usually treated with a six-month course of medicines, however, drug-resistant strains often require more medicines and can take up to two years to treat successfully.

“We have to find better ways of treating TB if we are to improve treatment outcomes for people with DR-TB,” added Ndjeka

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