Launch of Holistic Strategy to Tackle TB
The World Health Organisation (WHO) reports that South Africa is the third highest TB burden country in the world, with an estimated 857 TB cases per 100 000 population. Following Kwa-Zulu Natal and the Eastern Cape the Western Cape has 909 cases per 100 000 new TB infections in South Africa. During 2013/2014, 45 000 people were initiated on TB treatment. The Western Cape is faced with an increased incidence of newly diagnosed Drug Resistant (DR) TB patients, who have never had TB previously.
Faced with this reality, the Western Cape Government Department of Health has launched a holistic communication strategy to address stigma around the disease and to encourage early detection and treatment for DR-TB. The strategy will include a series of radio advertisements focussing on these three categories, but will also expand to include the important role families and communities need to play in this regard. Participative community interactions will include one-on-one discussions with the public at taxi ranks and train stations. The radio advertisements can be downloaded from www.westerncape.gov.za
Previously patients were hospitalised for a minimum of six months. The increased pressure on hospital beds led to a pilot study of decentralised management of DR TB clients in Khayelitsha sub-district in 2009. Lessons learned in the pilot resulted in change in provincial policy, leading to provincial-wide decentralised management of DR TB in 2011. This Policy Framework is based on sound evidence that decentralised DR-TB treatment provides more effective treatment for the patient, taking social and family pressures into consideration. In addition decentralised care eased the burden placed on the hospitals and through its functioning brought about a number of successes which led to the following:
- Patients could receive treatment in the community they live in, thus maintaining the family unit.
- A decrease in the amount of days to commencement of treatment, from an average of 72 days in the past, to an average of 11-23 days.
- The roll-out of GeneXpert, in the province which enables sputum lab results to be available within 12-48 hours.
- Establishment of the M (X) DR TB Review Committee, the purpose of this meeting is to review chronic DR TB cases that are failing treatment and to advise on appropriate management strategies.
Western Cape Minister of Health, Theuns Botha, who has been appointed for a second term of office, points out that the Western Cape has one of the highest TB burdens in the country even though the province has few mines. TB however is spread in poorly ventilated, confined environments , and therefore poses a risk to individuals within these specific environments. "We need to find another approach to preventing and treating TB. I am considering proposing TB screening into the school health system."
Even though the Western Cape has the highest TB cure rate in South Africa, the risk for new infections remains a serious challenge. More work is required to change behaviour and address misconceptions at an individual level, as well as efforts to address the more systemic and societal challenges.
To listen to the TB radio advertisement, click on the "play" button below.
English - Bitter Pill, Commitment and Symptoms
Afrikaans - Bitter Pill, Commitment and Symptoms
Xhosa - Bitter Pill, Commitment and Symptoms