Programme Director
Speaker of the Northern Cape Legislature
Members of the Northern Cape Provincial Legislature
Members of the Executive Council
Chairperson and Members of the Provincial Portfolio Committee on Health
Honourable Executive Mayor of Frances Baard District Municipality
Honourable Mayor of Sol Plaatje Local Municipality
All Municipal Councillors
Esteemed guests
Senior managers, the district manager and departmental officials from the provincial Department of Health
All non-governmental organisations (NGOs) and strategic partners
Representatives from all the different communities, political and religious institutions and structures across the district
Esteemed members of the media
Ladies and gentlemen
We would like to welcome all to the launch of a very important government campaign in our fight against tuberculosis (TB). Today we are launching the Provincial TB Contact Tracing Campaign here in the Frances Baard District as our build up towards the commemoration of World TB Day on 24 March 2011.
The high burden of TB in many developing countries makes TB control a priority public health concern that must be addressed through the primary healthcare network. The fight against TB, HIV, AIDS and sexually transmitted diseases (STIs) cannot be the sole responsibility of one sector, department, ministry or organisation. We want to use this campaign to mobilise communities and all relevant stakeholders to work more closely with the Department of Health and the Northern Cape Provincial Government to deal with the challenge of TB in the province. The fight against TB is the responsibility of us all. It necessitates the involvement of all stakeholders to improve socio-economic conditions by addressing poor living conditions, the high unemployment rate and prevalence of HIV.
Ladies and gentlemen, as the ANC led government of South-Africa, we have an obligation towards the healthcare of our people. In this light, as a response to the call of our people during the April 2009 elections, Health has been prioritised as the one of the five key areas together with crime, education, rural development and job creation for the next five years. In addition, government developed a Ten Point Plan to address the service delivery challenges faced by the health sector. The TB Contact Tracer Campaign falls under Point 7-Accelarated implementation of the HIV & AIDS and Sexually Transmitted Infections National Strategic Plan 2007-2011 and increased focus on TB and other communicable diseases and Point 8 - Mass mobilisation for better health for the population.
The Global Plan to Stop TB 2006–2015 indicates that TB kills two (2) million people per year. The breakdown in health services, the spread of HIV/AIDS and the emergence of multi-drug resistant TB (MDR-TB) are contributing to the worsening impact of the disease. It is estimated that between 2000 and 2020, nearly one billion people will be newly infected. Two hundred (200) million people will get sick. Thirty-five (35) million people will die from TB if control is not further strengthened.
Programme, director, the number of TB, MDR and XDR TB cases in the province is on the rise. The number of new TB cases increased from six thousand one hundred and twenty-seven (6 127) in 2004, to eight thousand one hundred and ninety-two (8,192) in 2008. This marks an increase in the TB incidence rate from 552 per 100,000 population to 738 per 100,000 population.
Out of the 10 503 TB cases diagnosed in the Northern Cape Province, 3896 of them were from the Frances Baard District, totalling thirty-seven(37) percent of the TB burden in the province. The district has a high prevalence rate of HIV which stand at 22,1% which is higher than the provincial average of 16,5%. During 2010, the district diagnosed fifty-eight (58) MDR-TB cases and six (6) XDR-TB patients. This increase in the number of TB cases in the province indicates that our strategies implemented to combat TB are not yielding desired results, could be attributed to intensified TB case finding through TB awareness campaigns. On the other hand poor living conditions marked by poor infection control systems at community level together with increased HIV infections exacerbate the scourge of TB in the province. The Department of Health in partnership with all stakeholders have to fight the scourge of TB as a collective.
Ladies and gentlemen, in the process of taking responsibility of your health, you should get tested for TB if you display any of the following symptoms – coughing for more than two weeks, coughing up blood, no appetite, chest pains, weight loss, lumps and swellings, tiredness or weakness of the whole body, sweating at night, even when it is cold, getting fever which comes and goes and becoming short of breath for no reason. If you are living with someone who has TB, it is important and essential to get yourself tested at the nearest healthcare facility to start treatment for at least six months. Important to remember is treatment is free of charge. An urgent request is not to stop TB treatment until a healthcare worker has indicated to you to do so. TB treatment has been designed in such a way that is requires regularity, accuracy and endurance, otherwise it will not work.
Case detection of tuberculosis under public DOTS programmes is still low and there is currently a search for new ways to improve these programmes. For the province to achieve the MDG targets and national TB targets, the World Health Assembly in 1991, aimed at detecting 70% of new infectious TB cases and successfully curing 85% of these cases. Currently, around 50% of the estimated of new cases each year are reached, detected and treated. These targets – which are considered too conservative by many groups – can only be met if the response from the TB community shifts more decisively from passive case-finding to active case detection.
The TB tracer project implemented in the Frances Baard District since 2008 is bearing fruit resulting in improved TB treatment outcomes. More than 80% of the TB treatment defaulters in the district have been traced and placed back on treatment.
The Implementation of the Directly Observed Treatment Short Course (DOTS) strategy can accelerate the decline in the annual rate of TB infections in our province, however effective Implementation of the DOTS strategy for tuberculosis (TB) control depends on a wide range of health service providers, including the community. The prevention and control of TB is still a challenge and thus warrants the continuous engagement of all stakeholders, especially civil society and non-governmental organisations as to address the impact of TB in communities.
Programme director, this campaign focus will be in the Frances Baard District. One thousand seven hundred and twenty-four (1 724) smear positive PTB cases, MDR & XDR TB index cases diagnosed during 2010 have been listed and will be followed-up at their homes. Household family members and close contacts will be traced and screened for TB. It is estimated that each household in the district has about five members and therefore the target.
The format of the campaign will entail:
- On-the-spot sputum specimen collection will be done. Contacts will not be referred to the clinic to be tested, history informs us that very few of the contacts show up at the clinic for testing
- New cases will be referred for treatment & DOT. TB patients that were defaulting on treatment will be traced where necessary.
- Close contacts of M(X) DR-TB patients are people living in the same household, or spending many hours a day with the patient in the same indoor space. Contacts exposed to M(X) DR-TB patients and who are likely to be newly infected will be evaluated to assess the likelihood of the actual infection being an M(X) DR-TB strain of M. tuberculosis. The Closeness and intensity of MDR-TB exposure refers to Sharing air space e.g. living in the same household or sharing a hospital ward with a confirmed MDR-TB case is regarded as higher risk; exposure in small, enclosed, poorly ventilated space is more likely to result in transmission than a large, well-ventilated space
- There will be 10 teams per day visiting the households, each team comprising of Nurse, CHCW, Lay counselor, Data capturers, provincial and district officials, partner organisations representatives.
- During the last week of the campaign, the media/journalists will join the teams during these visits to capture and reflect on the experiences of TB patients and healthcare workers in caring for the patients.
- Proper health education will be given to family members on signs and symptoms of TB and answer all questions asked
- Leave pamphlets with information about TB and DR TB will be distributed
- One clinic with catchment population will be visited per week, smaller areas to be merged
- Mobilisation trucks (road show types) with stage, sound will go through the communities spreading TB and HIV messages,
For those patients diagnosed with TB, will be started on treated and those diagnosed with MDR and XDR TB during this campaign will be referred to a specialised MDR TB centre at West End Hospital-Kimberley.
Ladies and gentlemen, despite the above mentioned interventions in an attempt to overcome the TB challenge, I want to reiterate that we must always be reminded that TB is curable. We call upon patients not to stop TB treatment until a healthcare worker has indicated to you to do so. TB treatment has been designed in such a way that is requires regularity, accuracy and endurance, otherwise it will not work. What we found in our efforts to combat TB, there is the lack of commitment and responsibility from our patients during their treatment. These include:
- When people have TB symptoms they do not immediately go to the nearest clinic to test themselves.
- Many of our people still do not complete their TB treatment, which is important if you want to be cured; and if you don’t want to get more serious forms of TB.
- Many people still live in places that are not clean and some do not undertake simple steps such as opening of the windows at home in the morning to allow for fresh air.
The ANC led government’s HIV Counselling and Testing (HCT) Campaign is a direct response aimed at increasing our efforts to address the scourge of HIV and AIDS in our province and our country. This campaign is undertaken under the banner: “I am responsible...We are responsible... South Africa is taking responsibility”. We encourage everyone to take personal and collective responsibility to stop the spread of new HIV infections, provide care and support to those living with HIV and to ensure access to treatment for all people in need.
Remember, HIV, AIDS and TB does not discriminate.
In conclusion, as government we call upon all the citizens of the province to be part of and contribute positively towards governments programmes and campaign aimed at improving the lives and the health of our people.
We believe that working together, we can do more!.
Thank you!
Kealeboga!
Source: Northern Cape Provincial Government
