Plan
1 August 2006
Minister of Health Dr Manto Tshabalala-Msimang is to lead a major national
blitz into four districts with the highest cases of tuberculosis (TB) and low
cure rates as part of the Department of Healthâs efforts to address the major
problem of TB in the country.
The Department has identified Nelson Mandela Metro and Amatole District in
Eastern Cape, Ethekwini Metro in KwaZulu-Natal (KZN) and Johannesburg Metro in
Gauteng as districts posing the highest challenge of TB in the country.
Minister Tshabalala-Msimang accompanied by all Health MECs will be leading
campaigns in Eastern Cape, Gauteng and KZN (3, 4 and 6 August respectively),
galvanising support for TB control interventions at provincial and local
level.
On Friday, August 4, the Minister will meet the South African Business
Coalition on HIV and AIDS (SABCOHA) in Johannesburg to mobilise business
support and later participate in a community-based TB awareness campaign in
Soweto.
Tuberculosis is a major problem in the country with more than 270 000 people
suffering from the disease in 2004 and at least 12% of TB patients defaulted
from treatment.
The most affected provinces are Eastern Cape, KwaZulu-Natal, Gauteng and
Western Cape which contribute about 80% of the total TB burden in the country.
In addition to bigger population that makes up these provinces, major factors
affecting incidents of TB are:
* migration of patients
* lack of TB awareness and late detection of patients
* lack of awareness about necessity to complete treatment
* increasing number of patients with multi-drug resistant TB
* inadequate coverage of Directly Observed Treatment Strategy (DOTS),
* inadequate financial and human resource support for the TB control
programme
* poor access to laboratory.
In August last year, African Ministers of Health resolved at a World Health
Organisation (WHO) meeting in Maputo to declare TB an emergency in Africa and
agreed to commit more human and financial resources to support TB control
programmes.
Arising from this resolution, the South African Department of Health
developed the National TB Crisis Management plan with a budget of R36,8 million
to improve detection and cure rates and reduce treatment default rate in the
country.
The Plan seeks to improve systems necessary to support the TB control
programme. This includes better co-ordination of interventions at national,
provincial and local levels, improving laboratory services to reduce turn
around time for specimens and increasing efficiency of data collection and
tracking of patients.
The other component of the Plan is social mobilisation and communication
campaign in the four focus areas and nationally. The challenge with TB is to
improve awareness about the symptoms, encourage testing and assisting the
patients to complete their treatment for the period of six months.
Failure to complete TB treatment poses major challenges including
development of multi drug resistant TB. Government spends at least R400 per
patient for treating ordinary TB. For multi-drug resistant TB, the cost of
treatment dramatically increases to R24 000 per patient (including
hospitalisation and more expensive drugs).
There are many factors contributing to patientâs failure to complete
treatment. A general lack of treatment compliance culture, high levels of
poverty and food insecurity and lack of support within families and communities
are some of them.
The social mobilisation component of the TB plan addresses these factors
through an intensive communication programme which includes community awareness
campaigns in focus areas, staff training and mobilisation of Directly Observed
Treatment (DOT) supporters that are assigned to specific patients to encourage
them to complete treatment.
TB is curable even in the presence of HIV and AIDS. Success or failure is
determined by patientâs ability to complete treatment.
Table 2: The following table shows the number of TB patients reported in the
identified districts, latest smear conversion rates and treatment outcomes for
2004
Eastern Cape: Nelson Mandela Metro
District size: 1 952 sq km
Population district barometer: 1 028 016
No of new TB patients reported: 8 115
Latest smear conversion rates: 60%
Cure rates: 42%
Default rates: 16%
Eastern Cape: Amatole
District size: 23 675 sq km
Population district barometer: 1 657 901
No of new TB patients reported: 7 906
Latest smear conversion rates: 53%
Cure rates: 31%
Default rates: 11%
KwaZulu-Natal:
eThekwini
District size: 2 292 sq km
Population district barometer: 3 240 517
No of new TB patients reported: 24 198
Latest smear conversion rates: 49%
Cure rates: 32%
Default rates: 23%
Gauteng:
City of Johannesburg
District size: 1 644
Population district barometer: 3 578 392
No of new TB patients reported: 15 323
Latest smear conversion rates: 72%
Cure rates: 61%
Default rates: 11%
Contact: Sibani Mngadi
Cell: 082 772 0161
Issued by Department of Health
1 August 2006
Source: Department of Health (http://www.health.gov.za)
