Officials under pressure to contain deadly TB
Pastor Dale Morgan
SOUTH AFRICA: Officials under pressure to contain deadly TB*
13 Sep 2006 17:47:39 GMT
Source: IRIN
JOHANNESBURG , 13 September (IRIN) - Health officials in South Africa
are fighting to contain the spread of a deadly, drug-resistant strain of
tuberculosis (TB) after an HIV-positive woman with the disease refused
treatment and walked out of a Johannesburg hospital.
Doctors have since located and quarantined the woman, but fear she might
have infected several others with extremely drug resistant tuberculosis
(XDR TB), a virulent disease that has already killed 52 people in the
east-coast province of KwaZulu-Natal.
"We have collected the women with an ambulance and will seek a court
order to get her back into hospital if she again refuses treatment,"
said Dr Abdul Rahman, chief of operations at Gauteng Province's
Department of Health.
"We will now trace her contacts with hospital staff and members of her
family and anyone else, and test them for the XDR tuberculosis strain,"
he said. "If there are any signs she has spread the disease we will
isolate those patients and begin treatment immediately."
The emergence of XDR tuberculosis has put doctors and health officials
on high alert across South Africa, where one in nine of the population
is HIV-positive and an estimated 900 die every day from AIDS.
Medical experts from the World Health Organisation and America's Centres
for Disease Control gathered in Johannesburg last week and urged
immediate action to fight XDR TB, fearing South Africa's high rates of
HIV could speed the spread of the deadly TB through the population.
All 52 patients killed by XDR TB in KwaZulu-Natal were HIV positive and
died within an average of 16 days after diagnosis. Worryingly for the
scientific community, all the patients were receiving antiretroviral
(ARV) therapy at the time.
"HIV has the potential to fast track XDR TB into an uncontrollable
epidemic," said Dr Karin Weyer, TB Research Director at the South
African Medical Research Council (SAMRC). "Infection control precautions
are needed now, and must be scaled up without delay in settings where
HIV patients are brought together."
South Africa's Department of Health, lampooned by critics for
championing a diet of garlic, lemon and African potato as an alternative
treatment for HIV/AIDS, has promised to roll out two powerful antibiotic
drugs as early as next week to fight XDR TB.
"The Department of Health is making progress in ascertaining supply of
additional drugs - Capreomycin and Para Amino Salicylic Acid - to deal
with extremely drug resistant tuberculosis, with a local company
agreeing to provide one of the drugs," the Department of Health said in
a statement.
"These drugs are being reintroduced because of resistance to the first
and second line of drugs. There has been no invention of new TB drugs
over the past four decades ... The XDR TB strain has resistance to all
first-level drugs [used to treat ordinary TB] and it also has resistance
to two of the major classes of the second-level drugs used to treat
patients with multidrug-resistant [MDR] TB," the department said.
KILLS 1.7 MILLION ANNUALLY
TB, an airborne disease, spreads much like the common cold through the
coughs and sneezes of infected people, killing an estimated 1.7 million
people a year around the world, according to the SAMRC. The first
symptoms of the illness include weight loss, fever and night sweats. In
the advanced stages victims cough up blood. If untreated, TB can kill a
patient by gradually boring holes in his lungs.
TB poses an acute threat in South Africa, where half the adult
population has latent TB. It is the most common opportunistic infection
in HIV-positive people, and the health system is already strained by
huge caseloads of HIV/AIDS. Overcrowded townships, some plagued by
Victorian standards of hygiene and sanitation, present an ideal
environment for its spread. Only about half the treatable cases are cured.
Officials at Gauteng's Department of Health called for calm, saying the
spread of XDR TB was "neither an epidemic nor a crisis", and they were
working to determine whether the XDR found in Johannesburg was the same
as the KwaZulu-Natal strain. They would meet with specialists to devise
a treatment programme.
The SAMRC has laid out a seven-point programme to combat the disease,
including increased research into anti-TB drugs and promoting universal
access to ARVs, while urging the government to set out an emergency plan.
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