Call for new approach on drug-resistant TB

Call for new approach on drug-resistant TB

The French humanitarian agency, Doctors Without Borders (MSF), has called for a new approach in dealing with patients with Multi-Drug Resistant Tuberculosis.

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The audio is in isiZulu. See the English summary below.

MABUTHO: Njengoba uqhubeka umhlangano owaziwa ngele ‘€œ38th Union World Conference on Lung Health’€ omayelana nezifo eziphathelene namaphaphu kubalwa ne TB, eCape Town, inhlangano yodokotela ezimele iDoctors Without Borders, ithi kumele kuguqulwe indlela yokwelapha isifo se TB engalapheki ngokusetshenziswa kwamakhambi ajwayelekile alesisifo esaziwa ngele Multi-Drug Resistant Turberculosis. kwenziwe imizamo ephuthumayo yokuthola amakhambi angcono ukulwisana naloluhlobo lwe TB. UDr. Eric Goemaere, oyinhloko yehhovisi lalenhlangano eKhayelitsha, eCape Town, uthi indlela yokulapha iMulti-Drug Resistant Turberculosis ekhona njemanje ayisebenzi. Ngokwendlela okulashwa ngayo lesisifo labo abatholakala ukuthi banaloluhlobo lwe TB bavama ukuhlaliswa ngabodwana esibhedlela isikhathi esithi asibe izinyanga ezingu 18 kuya kwezingu 24. Kanti kumele badle amaphilisi isikhathi esifanayo. UDr Goemaere uthi okuyikhona okwenza isimo sabaguliswa ilesisifo sibe sibi impatho engeyinhle abayithola ezibhedlela. Uthi lokhu kungaphathwa kahle kweziguli ezineMulti-Drug Resistant Tuberculosis ezibhedlela kwenza ukuthi abantu abaningi uma bethola ukuthi banayo bavele banyamalale, bangayi ezibhedlela.

DR ERIC GOEMAERE: In those hospitals, there are no dialogues and there is total misunderstanding’€¦Patients are stigmatized, they are excluded from society, they are locked there. So what do they do when we start to diagnose them? They disappear.

MABUTHO: UDr Goemaere uthi amakhambi anikwa iziguli ezinalesisifo mabi ngendlela yokuthi kudingakala ukuthi odokotela bazincenge ukuthi ziwaphuze. Labo abane Multi-Drug Resistant Turberculosis badla amaphilisi angaphezulu kuka 20 ngosuku baphinde baphuze umuthi ububi bawo obungechazwe owaziwa ngele para-aminosalicylic acid granules izinyanga ezingu 18 kuya eminyakeni emibili.

DR ERIC GOEMAERE: You have to convince your patient everyday to drink this liquid because they know that for two hours they going to be totally nauseous. They have to take this for 18 to 24 months.

MABUTHO: UDr Goemaere uthi isixazululo sime ekuthenini kuxoxiswane neziguli eziphethwe iMulti-Drug Resistant Turberculosis nokuthi futhi kuqikelelwe ukuthi ziyafundiswa ngalesisifo. Uthi okunye okubalulekile ukuthi kutholakale nezinye izindlela zokulapha lesisifo ngoba le ekhona njengamanje, ephoqelela iziguli ukuthi zidle amaphilisi angaphezulu kuka 20 kanye nalomuthi omubi ipara-aminosalicylic acid granules nsuku zonke kuze kuphele iminyaka emibili, ayamukeleki.

DR ERIC GOEMAERE: We have to re-install dialogue with those patients and offer them alternatives. Alternatives in terms of adherence support, alternatives in terms of understanding of their disease and alternatives in terms of treatment because it is impossible to keep patients on treatment for two years with the kind of drugs we have today.

MABUTHO: UDr Carole Mitnick wase Nyuvesi yase Harvard, eMelika osanda kubhala umbiko osihloko sithi ‘€œBuilding Clinical Trials Capacity for Tuberculosis Drugs in High-Burden Countries’€, nalapho enxusa khona ukuthi kwenziwe okuthile ukuthola izindlela ezintsha zokulapha lesisifo ukhala ngokuthi nakuba ingaphezulu kuka 60 iminyaka kwatholakala iMulti-Drug Resistant Turberculosis kube khona ukuhudula izinyawo ekutholeni amakhambi angcono okulapha lesisifo. Uthi kumazwe asathuthuka kunomuzwa wokuthi indlela engcono yokuselapha ukuthi labo asebenayo bavalelwe egumbini labo bodwa ukuze bangatheleli abanye ngenxa yokuthi kuthathwa ngokuthi kunzima ukuyelapha.

DR CAROLE MITNICK: It has largely been ignored, with the exception of in extremely wealthy settings. This is really due to a perceived lack of importance of Multi-Drug Resistant Tuberculosis’€¦The perception has been that the treatment for MDR TB is too hard and too toxic. Therefore, the alternative in resource-poor settings has been to just isolate people, hope that they don’€™t transmit to anyone else, and let them die.

MABUTHO: Oka Mitnick uthi sesifikile isikhathi sokuthi kuqhutshekwe kuhlolwe ukuthola izindlela ezingcono zokunqanda iMulti-Drug Resistant Turberculosis.

DR CAROLE MITNICK: The problem is so enormous and the urgency so great that there really can be no additional delay in developing new regimens for drug-resistant disease.

MABUTHO: Ngokombiko wophiko oluphathelene nezindaba zezempilo enhlanganweni yezizwe iWorld Health Organisation (WHO) balinganiselwa ku 450 000 abantu abaphathwa iMulti-Drug Resistant Turberculosis minyaka yonke emhlabeni jikelele. Kanti eNingizimu Africa, kubikwa ukuthi bangu 6 000 abantu abangenwa iMulti-Drug Resistant Turberculosis minyaka yonke.

English summary.

Call for new approach on drug-resistant TB

The French humanitarian agency, Doctors Without Borders (MSF), has called for a new approach in dealing with patients with Multi-Drug Resistant Tuberculosis.

According to Dr Eric Goemaere, head of MSF in South Africa, the current strategies to control Multi-Drug Resistant Turberculosis are failing. These require that MDR-TB patients be isolated for a period of six months or longer. He says what worsens the situation is the ill-treatment MDR-TB patients endure in hospitals.

‘€œIn those hospitals, there are no dialogues and there is total misunderstanding’€¦Patients are stigmatized, they are excluded from society, they are locked there. So what do they do when we start to diagnose them? They disappear,’€ he said.

MDR TB patients may take as many as 25 pills a day, which include para-aminosalicylic acid granules, known for acute nausea as a side-effect.

‘€œYou have to convince your patient every day to drink this liquid because they know that for two hours they’€™re going to be totally nauseous. They have to take this for 18 to 24 months,’€ said Dr Goemaere.

Dr Goemaere says the solution lies in communicating with the patients and to ensure that they are educated about the disease.

‘€œWe have to re-install dialogue with those patients and offer them alternatives. Alternatives in terms of adherence support, alternatives in terms of understanding of their disease and alternatives in terms of treatment because it is impossible to keep patients on treatment for two years with the kind of drugs we have today,’€ he said.

Speaking via telephone from the United States, Harvard Medical School’€™s Dr Nicole Mitnick, and the lead author of the paper, ‘€œBuilding Clinical Trials Capacity for Tuberculosis Drugs in High-Burden Countries’€, says less has been done to find better treatment for MDR TB.

‘€œIt has largely been ignored, with the exception of in extremely wealthy settings. This is really due to a perceived lack of importance of Multi-Drug Resistant Tuberculosis’€¦The perception has been that the treatment for MDR TB is too hard and too toxic. Therefore, the alternative in resource-poor settings has been to just isolate people, hope that they don’€™t transmit to anyone else, and let them die,’€ she said. ‘€œThe problem is so enormous and the urgency so great that there really can be no additional delay in developing new regimens for drug-resistant disease’€, she added.

According to the World Health Organisation (WHO) every year, 450 000 new MDR-TB cases are estimated to occur worldwide, including 6 000 in South Africa.