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

MABUTHO: Naphezu kokuba iExtremely Drug Resistant Tuberculosis kudala ikhona kodwa iqale ukugqama kakhulu kuleli emva kokutholakala kwenqwaba yeziguli ezinaloluhlobo lwe TB esibhedlela iChurch of Scotland endaweni yase Msinga, maphakathi nesifundazweni saKwaZulu-Natal. I Extremely Drug Resistant Tuberculosis ihlukile kwi TB ejwayelekile ngoba yona kayilapheki ngokusebenzisa amakhambi asetshenziselwa ukulapha iTB ejwayelekile. Sihambele endaweni yase Msinga lapho sixoxisane khona noDr Tony Moll ongumqondisi wesibhedlela  iChurch of Scotland nokunguyena owayehola ithimba elalelapha iziguli ezingu 53 ezatholakala ukuthi zine XDR TB ngonyaka ka 2006. UDr Moll uthi leziziguli bezinegciwane le HIV kanye nomthelela wesifo sofuba.

Dr TONY MOLL:   We were treating them for both TB and HIV together’€¦They started to deteriorate and we couldn’€™t understand this. We first thought it was the antiretroviral treatment that was failing and we checked their CD4 counts and their viral loads and they were good. The antiretroviral therapy was working.

MABUTHO: Uthi kuthe besakhungathwe ilokhu kungalapheki kwaleziziguli zabo base bethola ucingo oluvela elaboratory enkulu eThekwini betshelwa ukuthi iziguli zabo zine TB eyingozi kakhulu eyaziwa ngele Extremely Drug Resistant Tuberculosis. Uthi washaywa uvalo kwaxega namadolo ecabanga ngabasebenzi basesibhedlela okwakungaba nabo sebewutholile lomthelela kuleziziguli njengoba uhamba ngomoya.

Dr TONY MOLL: I tell you I really felt just as if all my energy just drained out of me. I was really just thinking of the consequences for us as health care workers’€¦. You know for many years we were working with HIV and we got used to the idea of transmission of HIV from the patient to the health care worker and it took us quite a while to feel quite comfortable with HIV. But this was a completely different ball game. This is air-borne transmission.

MABUTHO: Uthi ngalesisikhathi betshelwa ukuthi iziguli zabo zinale TB eyingozi babengenalo ulwazi olugcwele ngayo kangangokuthi ngisho igama leli elithi iExtremely Drug Resistant Turbeculosis liqhamuke kamuva ngoba bona babeyibiza ngokuthi iHighly Drug Resistant TB ngalesosikhathi.

Dr TONY MOLL: Those days it wasn’€™t even called XDR TB. We didn’€™t have a name for it. We were fumbling around with names like Highly Drug Resistant TB – that type of thing. It was only later on that it was called XDR TB.

MABUTHO: Kubantu abangu 53 bokuqala okwatholakala ukuthi babephethwe iExtremely Drug Resistant Turbeculosis esibhedlela sase Msinga abangu 52 babo bashona emva kwesikhashana kutholakele ukuthi banaloluhlobo lwe TB. Lokho kwenza ukuthi loluhlobo lwe TB lusatshwe kakhulu. Kwathi nabantu abaningi abaqhamuka ngaphandle besaba ukuyosebenza endaweni yase Msinga. UDr Moll uthi okwenza kwaba nokwethuka kakhulu indlela abezindaba ababebika ngayo ngalesisifo njengoba ethi elinye lamaphephandaba laqhamuka nesihloko esethusa kakhulu esasichaza indawo yase Msinga njengedolobha lokufa.

Dr TONY MOLL: What happened was unprecedented media coverage… One newspaper came out (with) a front page (headline): ‘€œKZN town of death’€. And there was a huge photograph of what looked like a very sick thin patient under a white sheet and a nurse dressed in black hovering over the patient. And this really created fear. People kind of didn’€™t know what really to imagine and didn’€™t really know what was happening.

MABUTHO: UProfessor Bruce Margot uyinhloko kuphiko olulawula iTB emnyangweni wezempilo esifundazweni saKwaZulu Natal. UMargot uthi ukutholakala kwe Extremely Drug Resistant Tuberculosis esibhedlela iChurch of Scotland, kusize kakhulu ekushintsheni indlela lesisifo ebesibukwa ngayo njengoba ethi bese sithanda ukuthi singanakwa.  

Prof. BRUCE MARGOT: Tugela Ferry’€¦renewed the interest in TB that has been lacking. So, things like new diagnostic methods’€¦quicker diagnostic methods’€¦shorter treatment regimens, better drugs to manage it – it’€™s renewed the interest in finding these’€¦which was starting to wane and going along very slowly’€¦ So in a way, although, it’€™s not good news, it helped us.

MABUTHO: UDr Moll naye uyavuma ukuthi ukutholakala kwaloluhlobo lwe TB kuye kwasiza kakhulu ekuthenini sibhekisiswe kabusha lesisifo. Uthi emva kwalesisigameko sokutholakala kwabantu abangu 53 ababenale TB eyingozi amalunga omphakathi wase Msinga aqala eza ngobuningi bawo efuna ukuhlolelwa lesisifo.

Dr TONY MOLL: We had a very good response from the community. We had lots and lots of patients coming to the hospital saying ‘€œI’€™m coughing. Can you check me out and take an x-ray and make sure I don’€™t have TB?’€

MABUTHO: Nakuba i XDR TB kwaziwa ukuthi iyabulala,   kepha uDr Moll uthi unazo iziguli ezinale TB azibona zithembisa nakholwa ukuthi zizogcina zilapheke ngokugcwele ngokuhamba kwesikhathi. Ngokwezibalo ze World Health Organisation (WHO) babalelwa ku 40 000 abantu abatholakala ukuthi bane XDR TB minyaka yonke, emhlabeni jikelele. INingizimu Africa ingelinye lamazwe amabili anemishini ekwazi ukuthola loluhlobo lwe TB ezwenikazi lase Africa.

See the English summary below.

XDR TB has re-awakened focus on TB

The outbreak of Extensively Drug Resistant Tuberculosis (XDR TB)  in Tugela Ferry in the Msinga area of KwaZulu-Natal in 2006, marked a turning point in the fight against TB.

It all began when a group of 53 patients co-infected with HIV and TB failed to respond well to TB treatment, says Dr Tony Moll, Principal Medical Officer at the Church of Scotland Hospital in Tugela Ferry, where the patients were admitted.

‘€œThey started to deteriorate and we couldn’€™t understand this. We first thought it was the antiretroviral treatment that was failing and we checked their CD4 counts and their viral loads – and they were good. The antiretroviral therapy was working,’€ said Dr Moll.

While he and his colleagues were still confused about why patients continued to deteriorate he got news from the central laboratory in Durban informing him that the patients were suffering from an Extensively Drug Resistant TB. He says the news came as a shock to him and his colleagues.

‘€œI tell you I really felt just as if all my energy just drained out of me. I was really just thinking of the consequences for us as health care workers’€¦. You know for many years we were working with HIV and we got used to the idea of transmission of HIV from the patient to the health care worker and it took us quite a while to feel quite comfortable with HIV. But this was a completely different ball game. This is air-borne transmission,’€ said Dr Moll.

The news spread like wild fire all over the country and abroad.

‘€œWhat happened was unprecedented media coverage… One newspaper came out (with) a front page (headline): ‘€œKZN town of death’€. And there was a huge photograph of what looked like a very sick thin patient under a white sheet and a nurse dressed in black hovering over the patient. And this really created fear. People kind of didn’€™t know what really to imagine and didn’€™t really know what was happening,’€ said Dr Moll.

Dr Moll says as bad as the XDR TB outbreak was, what came out of it was that it, at least,  helped to create awareness and to renew interest in TB among the community of Tugela Ferry and surroundings.

‘€œWe had a very good response from the community. We had lots and lots of patients coming to the hospital saying ‘€œI’€™m coughing. Can you check me out and take an X-ray and make sure I don’€™t have TB?’€ Dr Moll said.

Prof. Bruce Margot is the head of the TB unit in KwaZulu-Natal’€™s Department of Health. He added that the outbreak helped both provincial government and the national government as well as the scientific and medical communities to strengthen strategies to fight TB.

‘€œTugela Ferry’€¦renewed the interest in TB that has been lacking. So, things like new diagnostic methods’€¦quicker diagnostic methods’€¦shorter treatment regimens, better drugs to manage it – it’€™s renewed the interest in finding these’€¦which was starting to wane and going along very slowly’€¦ So in a way, although it’€™s not good news, it helped us,’€ said Prof. Margot.

XDR TB has been recorded in 45 countries. According to the World Health Organization (WHO) about 40 000 people are diagnosed with XDR TB every year worldwide. However, few countries currently have the equipment to diagnose it. In the whole of Africa, South Africa is one of only two countries that have the diagnostic tools to identify the disease.