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R/£ Deadly TB on upward spiral
November 12, 2006 Edition 1
Chris Makhaye
AN alarming 267 new cases of extreme drug-resistant TB (XDR TB) have been detected in KwaZulu-Natal.
Another shocking revelation is that the disease has been found in 10 of the province's 11 health districts, and is not confined to the Tugela Ferry area, as was previously thought.
Doctors say this could have dire consequences for those suffering from HIV/Aids.
The latest figures come on the heels of a World Health Organisation (WHO) recommendation to provincial health authorities, urging them to re-test sputum samples in their laboratories for indications of XDR TB.
Over the past few months, 68 people are said to have died from the disease in the province.
A prevalence survey last month on sputum kept since January last year revealed the deadly XDR TB was now found in 10 of the 11 health districts in KwaZulu-Natal.
Tugela Ferry's Church of Scotland Hospital accounted for 181 of these cases, while 10 other health districts had 86.
In September this year the WHO suggested that all health institutions in the Southern African Development Community conduct surveys of TB patient sputums stored in laboratories since the beginning of last year to establish the extent of the problem. The aim was to contain the deadly TB strain and find effective ways of treating it.
KwaZulu-Natal's chief technical adviser on TB, Bruce Margot, said the initial results of the survey noted that XDR TB was found in all nine provinces, but KwaZulu-Natal was the worst affected.
Margot said the increase was a consequence of the WHO's new definition of XDR TB.
"They have softened the definition of diagnosing XDR TB. Before we used a very strict diagnosis and a patient had to be resistant to all second-line TB drugs to be declared to have XDR TB," he said.
The Church of Scotland Hospital, with 181 cases, dwarfs other hospitals in terms of the number of people with the deadly strain. The hospital said 133 patients had died from the disease since last year. Last week alone, the sputum of nine new patients was found to have the drug-resistant tuberculosis. In October, 24 new cases were diagnosed.
The head of TB control at the hospital, Dr Kenny Moll, said he was not surprised at the figures.
"We had expected the increase since the new definition came into effect last month. Our hospital has been vigorous in diagnosing people who show the symptoms of drug-resistant TB."
Most XDR TB patients at the institution were HIV-positive and the death rate of those patients was 73%.
"This is because the patients come to the hospital when their CD4 count is very low. Once we had diagnosed them we often did not have the necessary drugs to treat them," he said.
Margot said the latest statistics brought new challenges.
"These patients will have to spend two years in hospital, getting drugs such as capreomycin, which is injected."
He said the department had recently received the three drugs used to treat XDR TB. The department would, from tomorrow, begin testing new patients for XDR TB, especially where the survey had found a high prevalence.
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