South Africa has the sixth highest prevalence of tuberculosis in the world and is one of the 22 high-burden countries that contribute approximately 80 percent of the total global burden of all TB cases, according to the latest National Health World TB Day report compiled by the Department of Health
World Tuberculosis Day (WTBD) was commemorated on Thursday March 24 with the theme “Unite to end TB”.
In the Mitchell’s Plain and Klipfontein substructure, there has been an 82 percent success rate among TB patients on treatment, according to the provincial health department. TB services can be accessed at the Mitchell’s Plain Community Health Centre and City of Cape Town clinics.
Mark van der Heever, spokesman for the provincial Department of Health, said the Western Cape had the fourth-highest TB incidence rate in the country.
He said the TB incidence rate since 2009 had dropped from over 1 000 per 100 000 people. According to the department’s statistics, the treatment success rate for all kinds of TB was 82 percent in the 2013/ 2014 financial year.
Mr Van der Heever said with the effect HIV had on the population, it was important that all HIV-positive TB patients had access to anti-retroviral treatment (ART).
Last year the department screened 654 661 people for TB, and started 42 092 people on TB treatment.
“It should be highlighted that the province is gearing itself for showing maximum impact on the elimination of TB in the Western Cape and in South Africa. Although the province has such a good treatment success rate, all efforts should be focussed on TB prevention due to the number of cases defaulting on TB treatment,” he said.
Health MEC Dr Nomafrench Mbombo, said the Western Cape had been successful in rolling out treatment, screenings, prevention strategies and awareness, but it could not fight the disease alone.
“More residents in this province need to take greater ownership of their health. The rate of people who default on treatment still shows that people are not committing themselves to completing their treatment and regaining their health. Community structures and civil society must also take this message forward into society.
“The success of any health intervention strategy is heavily reliant on community support, engagement and involvement, especially with a social disease such as tuberculosis,” she said.
Dr Mbombo said that in 2015 many countries, including South Africa, had adopted the 90-90-90 strategy to help end the Aids epidemic. The aim is that by by 2020, 90 percent of all people living with HIV will know their status, 90 percent of those eligible for treatment with ART will be on sustained treatment, and 90 percent of people on ART will have suppressed viral loads. The strategy has also been adapted for TB, so that by 2020, 90 percent of vulnerable groups should have been screened for TB, 90 percent of people with TB should be diagnosed and started on treatment, and 90 percent of those treated for TB should be cured.
“Key populations for TB, such as informal settlements and mining communities were singled out for special attention. Planning has already commenced on how to operationalise this strategy. For TB, the ever increasing pool of infection will not get any smaller unless those who need treatment are put on treatment. Reports suggest since districts started offering TB screening to all those coming into health facilities, there is a marked increase in this area of work,” said Dr Mbombo.
Foundation programme manager Razaan Bailey said it was important that everyone came together to fight TB.
“One of the ways that we can do this is to stop stigmatising those with TB and HIV. As with any illness adherence to one treatment regime is important, and when we stigmatise against people who are ill, we make it more difficult for them to seek out the support they need and for them to stick to their treatment,” she said.
According to the World Health Organisation, TB ranks alongside HIV/Aids as the world’s top infectious disease killer. In 2014, 9.6 million people fell ill with TB and 1.5 million died as a result of the disease, including 380 000 people living with HIV. More than 95 percent of TB deaths occur in low- and middle-income countries, and TB is among the top five causes of death among women aged 15 to 44.
Patients should be screened for TB if they suffer fatigue, shortness of breath, an ongoing cough, weight-loss, fevers.