Editorial: Decentralise treatment for drug-resistant TB
Anyone can get drug-resistant tuberculosis DR TB from being sneezed or coughed on by the estimated 14 000 people who are infected, even if we have never had TB before.
Treatment for DR TB can take up to two years, is costly and often painful with some awful side effects – particularly if a person has extensively drug-resistant (XDR) TB.
The USA is inclined to keep people with DR TB in hospital in isolation wards until they have finished their treatment.
Yet South Africa has found that the most successful way of treating people with DR TB as outpatients at local clinics.
This might sound dangerous for patients’ families – but research has found that people are more likely to accept treatment if they can stay at home. Their families would have been exposed to TB already anyway, and once people have been on treatment for a few months, they are no longer infectious.
In places where hospital is the only way a person can get DR TB treatment, less than half of those who need treatment are likely to get it. There are long waiting lists for beds and many patients are daunted by having to spend six months in hospital.
Yet in Khayelitsha in the Western Cape, where people can get DR TB treatment at their local clinic then go home, around 90 percent of people who need it are on treatment, according to a report by Medicins sans Frontieres (MSF). The medical humanitarian organisation has been treating TB in the township since 2007.
Not only does the Khayelitsha programme reach more people but it is 40 percent cheaper than hospitalisation.
Based in part on the success of the Khayelitsha programme, the Department of Health (DoH) introduced a national policy of decentralised DR-TB care in 2011, enabling patients to be treated by primary health clinics, instead of in hospital.
But after four years, only 70 health facilities countrywide offer DR TB care instead of the 2 500 sites promised, according to MSF.
Urgent attention needs to be paid to decentralising treatment reach those who need care and to protect those still uninfected.- Health-e News
Author
Republish this article
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Unless otherwise noted, you can republish our articles for free under a Creative Commons license. Here’s what you need to know:
-
You have to credit Health-e News. In the byline, we prefer “Author Name, Publication.” At the top of the text of your story, include a line that reads: “This story was originally published by Health-e News.” You must link the word “Health-e News” to the original URL of the story.
-
You must include all of the links from our story, including our newsletter sign up link.
-
If you use canonical metadata, please use the Health-e News URL. For more information about canonical metadata, click here.
-
You can’t edit our material, except to reflect relative changes in time, location and editorial style. (For example, “yesterday” can be changed to “last week”)
-
You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third party platforms or apps like Apple News or Google News. Health-e News understands that publishers cannot fully control when certain third parties automatically summarise or crawl content from publishers’ own sites.
-
You can’t republish our material wholesale, or automatically; you need to select stories to be republished individually.
-
If you share republished stories on social media, we’d appreciate being tagged in your posts. You can find us on Twitter @HealthENews, Instagram @healthenews, and Facebook Health-e News Service.
You can grab HTML code for our stories easily. Click on the Creative Commons logo on our stories. You’ll find it with the other share buttons.
If you have any other questions, contact info@health-e.org.za.
Editorial: Decentralise treatment for drug-resistant TB
by kerrycullinan, Health-e News
March 23, 2015