TB programme a failure because patients ‘not educated’
Government’s TB programme is failing because it has not educated patients about their treatment in the way that HIV patients have been educated.
In addition, R50 000 was wasted in KwaZulu-Natal over a six-month period on processing TB sputum tests at Nkosi Albert Luthuli Hospital, the results of which were never claimed by the hospitals and clinics that sent them in.
This is according to Zinhle Thabethe, who works for iTeach, a TB and HIV implementation programme at Edendale Hospital in Pietermaritzburg.
‘I have been on antiretroviral drugs for five years and, because I was trained about taking the medication, I have never missed my ARVs even for a day,’ Thabethe told an international HIV/AIDS workshop in Durban over the weekend.
‘But,’ she added, ‘I have also had TB three times and have never been told about how the treatment works or even the consequences if I don’t finish my course of medication.’
Thabethe said that instead of educating TB patients, health workers referred them to Directly Observed Treatment Short-course (DOTS) volunteers who were supposed to monitor them taking their medication.
‘DOTS doesn’t work. You must teach us patients how to take our TB drugs rather than DOTS-ing us,’ she said..
Patients living in informal settlements have ‘no addresses and no DOTS volunteer is going to be able to follow them up if they don’t show up for their medication’, she added.
DOTS is the cornerstone of government’s TB programme. Yet less than half TB patients countrywide are cured at present, while in eThekwini and Msunduzi barely a third of TB patients are being cured.
However, Dr Sibongile Zungu, KwaZulu-Natal’s Chief Health Officer, said she found Thabethe’s rejection of DOTS while supporting the ARV rollout model to be ‘contradictory’.
‘TB patients are told about the disease and the treatment. If they are well enough to be discharged, they are requested to link to a DOTS person that would assist them to take their treatment,’ said Zungu.
‘It can be a DOTS volunteer but it can be anybody. This is just like the treatment buddy that an HIV positive person starting antiretroviral drugs is asked to identify to help them.’
Zungu also said that she knew nothing about the R50 000 being wasted on unclaimed TB tests.
‘I find that a bit strange as most hospitals are on the intranet and can link up to Albert Luthuli electronically for results. Besides, ordinary TB sputum tests are processed by local hospital laboratories. It is only when a patient is not improving and [drug] resistance is suspected that their sputum is sent to Albert Luthuli to be cultured.’