The Gauteng Department of Health this week unveiled new technology that will help protect and prevent the spread of tuberculosis (TB) amongst healthcare workers.

The Portacount Respirator Fit Tester is a device that will allow healthcare workers identify whether their personal protective equipment (PPE) fits properly, explained MEC for health in the province Dr Nomathemba Mokgethi. The device works with respiratory equipment such as gas masks, respirators, disposable masks such as N95, P1 and P2 disposable respirators.

Authorities identified ill-fitting PPE as one of the contributing factors that putting healthcare workers at risk of exposure to  TB and COVID-19, according to Mokgethi.

At an event marking World TB Day on 24 March, Mokgethi announced that the device will be distributed to health facilities around the province. Held at the Carletonville Civic Centre, the event also saw healthcare workers screened for TB, COVID-19, HIV and diabetes.

A safe environment for healthcare workers

Professor Muzimkhulu Zungu from the National Institute for Occupational Health lauded the department for introducing the fit tester device. Zungu highlighted the importance of providing employees with a safe environment and proper safety equipment.

“Generally there are two sizes, there is the regular and small,” Zungu said of face masks. “With the Fit Test, it will help you to know which one you should wear. There’s a number of things that tell us from this machine and we are launching this because we want to discourage people from just going into the workplace, taking a respirator, putting it on their face but not knowing if it is going to protect them.”

Zungu urged the  Gauteng Department of Health as an employer to ensure that healthcare workers’ safety, as is the law. A 2014 audit by the Department of Employment and Labour found that Gauteng had a compliance rate of between 9% and 30% in protecting workers from infectious diseases, he said.

“Our health [workers] deserve access to workers’ rights because it is our human right,” Zungu added.

Healthcare workers at higher risk of developing TB

In 2019 Margaret Damsisi, a 48-year-old community healthcare worker experienced a persistent cough and decided to seek medical attention. Doctors diagnosed Damsisi with TB.

“I had a cough that wouldn’t go away and I went to the clinic where I was advised to take a cough mixture and see if the cough would go away,” said Damsisi, who works at the Bekkersdal West community health centre. “When it persisted, I decided to consult again and that is when, after various tests, I was diagnosed with TB.”

With the support of her colleagues and family, she was able to adhere to the six months of TB treatment. Damsisi is the exception though, as many TB patients struggle to adhere to the treatment regime.

“I accepted the diagnosis and the staff together with my family, were very supportive. I took the treatment and after six months, I was healed,” she added.

Preventative TB treatment

Damsisi is advocating for the introduction of a one dose per week TB drug, 3HP. The drug is given to those at risk of developing TB, like people living with HIV and household contacts of those with TB.

It is meant to treat patients with latent TB, a form of the disease in which the tuberculosis bacteria remains in the patient’s body but is inactive. The pharmaceutical company Sanofi in partnership with the National Department of Health launched 3HP in 2019.

The drug has a shorter treatment regimen—12 weeks—making patient adherence easier and improving treatment outcomes. The current standard of preventative treatment takes 12 months, and has seen patients defaulting or even stopping treatment, resulting in inadequate prevention.

According to Dr Jebson Zingwari, who manages the TB portfolio at Sanofi, the 3HP treatment is currently available in four provinces.

“The treatment has been distributed to four provinces and will be distributed further down to the facilities. The government is working on a roll-out and training plan and once facilities are trained, implementation will begin,” said Zingwari.

The effects of COVID-19 on TB treatment

The COVID-19 pandemic has further affected patient adherence to preventative TB treatment. Zingwari says that 3HP can address this challenge.

“COVID has negatively affected the accessibility to facilities by patients as they are afraid of contracting the disease. As a result, some patients on TB preventive therapy and TB treatment have defaulted their treatment. The new shorter treatment regimen will reduce the number of facility visits a patient needs to do and therefore will improve uptake and adherence to TB preventive therapy. This will help to reduce TB in South Africa,” he said.

The Gauteng Department of Health has also launched a TB hotline, which they hope will encourage residents to seek testing and treatment for TB.

“This is the first of its kind in Gauteng and people are going to phone, WhatsApp or SMS if they have got the signs and symptoms of TB. It is also  going to help us in tracking and tracing the lost follow-ups,” said project manager of the hotline Maphefo Masango.

#TB || GAUTENG TBHOTLINE. Do you have TB related questions? Gauteng Department of Health has launched a hotline to trace and find patients that are lost to follow -up (LTF). pic.twitter.com/J5j7sV5FmR

— Tshwane District Health Services (@HealthTshwane) March 24, 2021

Through this service, patients will also receive a reminder to go and collect their results once they have been sent back to the clinic from the lab. Patients who have defaulted on their treatment can also reach out to the new TB Hotline by calling 0800 428 8364 or sending a WhatsApp message to 082 601 1000 for help. — Health-e News