TB cure rate poor in SA
Already South Africa has the second most people living with HIV in the world, only recently overtaken by India, and it is estimated that almost half of AIDS-related deaths in South Africa are caused by TB.
The South African Government spends millions on TB control and treatment every year to try and eliminate TB in South Africa. TB diagnosis and treatment is free in all public health facilities.
While the WHO announced this week that the global TB epidemic has leveled off for the first time since the WHO declared TB a public health emergency in 1993, South Africa is struggling to stem the tide.
The target set by the WHO in 1991 is to cure 85% of newly detected cases of smear positive pulmonary TB with the corresponding target set for 2005/6 by the national health department 65%.
When a person has the TB bacteria in their sputum (spit) when they cough, they are said to be ‘TB smear positive’. These are the people who are infectious and can pass the infection through droplets in the air when they cough and sneeze.
The smear conversion rate measures the proportion of infectious people who no longer have the TB bacteria in their sputum after two months of treatment and are therefore no longer infectious. This indicator is important as it measures how effective the initial treatment has been in stopping the transmission of TB.
According to the District Health Barometer (DHB) the current national target for smear conversion rate is 70% but in 2005 the average smear conversion rate for South Africa was just over 50%.
In Nkangala in Mpumalanga the smear conversion rate was a dismal 23% while Boshabela in Limpopo recorded a rate of over 80%.
Gauteng has the highest national average of 62,2%. In KwaZulu-Natal, rates range from 28,6% in Uthungulu to 64,7% in Amajuba.
Mpumalanga performed the worst with highest smear conversion rate 40,9%.
The DHB also shows that the metropoles have performed poorly in comparison to the rural districts. Both eThekwini and Nelson Mandela has smear conversion rates of less than 50%.
‘Given the high socio-economic status of these metros, it is obvious that the TB programme has not been given the adequate prioritization and attention from management that is deserves,’ the DHB authors said.
South Africa fared no better when measured against its cure rate ‘ the number of new smear positive TB cases who are shown to be smear negative at the end of six months.
In South Africa, the target is to cure 65% while the target set by the WHO is 85%. But South Africa’s cure rate in 2004 dropped to 50,8% from 56,7% in 2003.
Researchers have said this was an indictment of the management and monitoring of the TB programme across the country.
However, the number of TB cases has increased by 50% in three years from 2001 (188 696 cases) to 2004 (279 260 cases), according to the DBH. This is largely being driven by the HIV epidemic.
In KwaZulu-Natal, over 80% of patients with TB cases also have HIV, according to provincial TB manager Bruce Margo.
The symptoms of TB may include a persistent cough for more than 3 weeks, feeling weak, weight loss, having night sweats, chest pains or coughing up blood. If you have any of these symptoms contact your nearest clinic or doctor. ‘ Health-e News Service.
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