11 December 2008

Resistant TB hits hard in KZN

About two-thirds of the total number of 314 confirmed extensive drug-resistant tuberculosis patients in South Africa have died of the illness, according to new figures.

About two-thirds of the total number of 314 confirmed extensive drug-resistant tuberculosis (XDR-TB) patients in South Africa have died of the illness, according to acting Health Minister Jeff Radebe.

This translated into 215 deaths.

In a written reply to a question in the National Assembly, Radebe said 228 of the confirmed cases, which were most of them, were reported in KwaZulu-Natal.

Of these, 203 came from the Msinga area, in the Tugela Valley, with 25 patients reported from other parts of the province.

"The huge number of deaths has also been in the same area.

Reasons still unclear
"This is an area of concern, as it is not yet clear why this area is most affected and the reasons for such high death rates; we will be working with the province to conduct an epidemiological assessment of the XDR-TB epidemic in this area," he said.

A total of 201 people in KwaZulu-Natal had died of XDR-TB, while the Eastern Cape had 33 confirmed cases and five deaths, the Free State eight and two, Gauteng 13 and two, Limpopo five and one, and the North West had 10 confirmed cases and four deaths.

The Northern Cape and Western Cape had eight cases each and no deaths, while Mpumalanga had one confirmed case and no deaths.

Focus on early detection
Radebe said the health department had ensured that all existing MDR-TB patients currently on treatment were tested for second-line susceptibility, to ensure early detection of XDR-TB.

Close contacts of all confirmed XDR-TB patients had been screened and tested for TB.

The National Health Laboratory Services (NHLS) had increased staffing in the laboratories conducting second-line drug susceptibility testing and increased working hours to cope with the increasing demand for these tests.

"There are still challenges in this area, as the laboratory services are not accessible. Consultations with the NHLS are underway to increase access to culture and drug susceptibility testing and a service level improvement plan has been developed to address this," he said.

Diagnosis of drug resistant TB currently required culture and drug susceptibility testing, which had limitations in that the technique was slow and cumbersome.

By the time the results were available the initiation of treatment had been delayed and there had been spread of infection.

Rapid testing on the way
The department, together with the Medical Research Council (MRC), NHLS and FIND (Foundation for Innovative New Diagnostics) -- a foundation based in Geneva dedicated to improved diagnostic technologies for infectious disease endemic in developing countries, with its initial focus being tuberculosis – would embark on a demonstration project to evaluate the feasibility, impact and cost effectiveness of two rapid methods to diagnose resistant TB.

"These tests will enable us to know the results within a period of two days for first-line drug susceptibility and second-line drug testing will be done sooner, reducing the turn-around time for confirmation of second-line drug susceptibility, which currently takes 10-12 weeks."

The project had been endorsed by the World Health Organisation (WHO) Global XDR-TB Task Force, and the results would be presented to the WHO in 2008 for policy amendment, said Radebe.

In the meantime they would assist the country with early detection of patients with drug resistant TB, he added. – (Sapa)

Read more:
Multi-drug resistant TB
Rapid test for resistant TB

For more information on care and support of tuberculosis visit South African National TB Association (SANTA) or phone them on 011 454 0260.

March 2007


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