the North West
6 October 2006
XDR TB has emerged as a major threat to public health and TB control. It
presents enormous challenges to effective treatment and control of the disease.
In the North West province we are doing everything possible to deal with the
challenges posed by XDR TB.
Between 2002 and September 2006, there have been 10 XDR patients identified
in the province. Six of these are surviving. In 2000 there were just over 10
000 ordinary TB patients in the North West. In 2005/06 27 209 TB patients have
already been treated. This implies that there has been a 170 percent increase
in TB over the last six years. The rise of TB numbers is as a result of a
strengthening of the provincial TB programme with improved detection of cases,
as well as the impact of the HIV and AIDS pandemic.
The North West Province has a specialised Multi Drug Resistant TB (MDR TB)
unit in the Klerksdorp/Tshepong Hospital Complex. Established in 2001, it has
been recognised nationally as the best MDR TB unit in the country. It has a
successful track record of treating MDR TB patients. Among other things, the
MDR TB unit ensures thorough screening of all possible contacts of MDR and XDR
patients to prevent further infections.
MDR TB describes strains of TB that are resistant to at least two of the
main first line TB drugs. Treatment requires the use of second line drugs which
are more toxic, take longer to work and are costly. XDR TB on the other hand is
virtually incurable because it is also resistant to at least three of the
second line medication.
XDR TB is placing an increased strain on the limited resources of our public
health system. For example, an ordinary TB case costs about R700 and six months
to treat. MDR TB costs R32 000 per patient and takes two years to treat. People
can get XDR TB by defaulting treatment or rarely by direct infection. As many
as 14 percent of provincial TB patients default treatment that is why it is so
important that all TB patients get all the support from their families and
communities to complete the full course of treatment. The department will have
no choice but to hospitalise defaulters to ensure that they get cured.
Understandably the public is most concerned about XDR TB and would like to
know what they can do to protect themselves. Most importantly ordinary TB must
be cured. This can be done by taking the following steps. Firstly, prevent
getting TB by ensuring a healthy lifestyle and good nutrition. Secondly, going
to the clinic as soon as possible if you have any of the following symptoms
such as coughing for more than two weeks, losing weight and energy,
experiencing chest pains, night sweats or coughing blood. I would like to
remind the people of the North West that ordinary TB is curable even for people
who have HIV. And thirdly, as communities, to support anyone who is on TB
treatment by helping and watching them take their medicine every day for the
full six months. In addition the province is very mindful of the affected
families and will do what it can to assist families to visit their ill family
members on occasion as required.
Whilst XDR TB has raised the spectre of a future epidemic of virtually
untreatable TB there is no reason for alarm. The risk to the citizens of North
West of getting XDR TB is very small at this stage.
I wish to assure all our people that the department is doing all it can to
address the challenge posed by XDR TB. An 18-bed specialised isolated XDR TB
unit will be completed within four weeks. The 32 bed dedicated MDR TB unit is
being expanded to accommodate 50 patients. The province is working closely in
partnership with national Department of Health, the Southern African
Development Community (SADC) region as well as international agencies such as
the World Health Organisation (WHO) and the Centre for Disease Control in
Atlanta (CDC) in addressing the problem.
Due to the free movement of people, regional and international co-operation
is important.
We believe that while there may be reasons for concern, there is absolutely
no reason for alarm. We make and appeal to the Community Health Workers (CHW),
Directly Observed Treatment Short-Course (DOTS) and TB supporters and
Non-Governmental Organisations (NGOs) to continue and to strengthen their
efforts in case finding and support for those suspected or ill with TB, as well
as there families.
Contact:
Dr Andrew Robinson
Tel: (018) 387 5855
Mr Zakes Lesiba Molala
Tel: (018) 387 5627
Cell: 082 552 1319
Zakes Molala
Acting Departmental Spokesperson
Tel: (018) 387 5830
Fax: (018) 387 5830
E-mail: lmolala@nwpg.gov.za
Issued by: Department of Health, North West Provincial Government
6 October 2006
Source: North West Department of Health (http://www.nwhealth.gov.za)
