But the health department aims to have 86 mobile teams operational in the province by June to treat drug-resistant TB patients in their homes to contain the epidemic.

This is according to Bruce Margot, head of the provincial TB programme, who described XDR TB as ‘€œslowly smouldering’€.

The deadly XDR TB is resistant to at least four TB drugs and it kills most people who are infected with it.

More than half (51 percent) of the group of 60 patients diagnosed with XDR TB in 2006 have died while only 18 percent have been cured, according to research conducted at King George V Hospital by Dr Max O’€™Donnel.

In 2009, 199 cases of XDR TB were recorded in the province. While last year’€™s figure are not yet complete, Margot confirmed that XDR cases were increasing particularly in Ethekwini, Umgungundlovu, Ugu and Uthungula.

Dr Igbal Master, head of TB services at King George V Hospital, confirmed that they were treating XDR patients from all over the province. Last year, they had treated 187 patients, 80 of whom were from Ethekwini.

XDR TB is the result of years of a poor TB control programme where people have not completed their TB treatment, thus enabling the TB bacilla (germs) to mutate until normal TB drugs don’€™t work on them.

To address XDR TB in Tugela Ferry’€™s Umzimyathi district, the province piloted a community-based management programme as patients were very reluctant to be confined to distant King George V Hospital for up to two years.

‘€œWe have 11 teams operating in Umzimyathi that visit people with drug-resistant TB in their homes and give them treatment,’€ said Margot. ‘€œThis pilot has been very successful and all provinces have now been tasked with decentralising TB treatment.’€

Margot said that he favoured the mobile teams as there were limited hospital beds and it was hard to keep people in hospital for long periods.

‘€œBy going to patients’€™ homes and giving them their medicine and injections, it is easier for the patients; healthworkers see the patients every day and can screen the patients’€™ household for drug-resistant TB and you are preventing highly infectious people from coming into clinic and hospital waiting rooms and infecting others,’€ said Margot.

‘€œWe will continue to treat people in hospitals and clinics, but it would be ideal if we had enough mobile teams to treat people in their homes.’€

Health MEC Dr Sibongiseni Dhlomo stressed that drug resistant TB was created when patients interrupted their treatment, either because of ‘€œhealth system failures or because they were not motivated enough to finish it’€.

‘€œWe need to move away from saying patients defaulted on treatment because that means it is the patient’€™s fault. It could be the fault of the health system’€.