Health MEC Nomagugu Simelane-Zulu says KwaZulu-Natal is the epicentre of South Africa’s tuberculosis (TB) epidemic.
Simelane-Zulu said South Africa is one of 14 countries that have an exceptionally high burden of susceptible TB, TB and HIV co-infection and multidrug-resistant (MDR) TB according to the World Health Organization (WHO).
She said eThekwini had the highest number of cases of all provinces.
Simelane-Zulu said a TB Prevalence Survey, conducted in 2018, found an estimated number of 737 per 100 000 population were infected.
The estimated prevalence of pulmonary TB, which is contagious, in males 15 years and older, was more than 1 000 she said.
“This is approximately 1.6 times that of females, which is cause for concern – especially, given the fact that men generally prefer not to come to health facilities unless they are very sick, which needs to change,” said Simelane-Zulu.
While the number of reported cases declined from 1 128 in 2010 to 410 per 100 000 population recorded last year, this was more than double the WHO crisis marker, she said.
The department has implemented strategies to overcome the burden of TB through several interventions.
Simelane-Zulu said the department had scaled up the use of the GeneXpert Ultra machine, which shortens the time taken to receive TB test results.
Tests are processed in two hours rather than three and the new ultra per 100 000 population, the machine is able to detect 90% of the bacteria as opposed to 75% previously.
The department has also been focusing on TB prevention for people living with HIV, particularly through earlier initiation and scaling up of antiretroviral therapy.
Simelane-Zulu said a new 3HP approach, which is a shorter regimen that is taken two times a week for three months, will start from this month in eThekwini.
“It will replace the six to 12 months INH therapy, which has been used up to this point.”
EThekwini has also received two mobile X-ray clinics which the department said are able to produce TB results in a record time of 15 minutes.
“The province has plans to procure more such facilities in future.”
The MEC said new TB drugs, diagnostics, and vaccines were also being researched.
A new drug called Delamanid, which was introduced in April 2019, has been quite effective in treating extensively drug-resistant (XDR) TB patients with 350 patients already using the drug she said.
“It has fewer side effects, and is effective on XDR patients,” she said.
With a TB/HIV co-infection rate of 61%, which makes it difficult to diagnose TB, Simelane-Zulu said the urine LAM TB test has been introduced to address this challenge.
She said this test was less invasive and was helpful in the diagnosis of people who are too sick to produce a mixture of saliva and mucus coughed up from the respiratory tract and who have a CD4 (infection-fighting cells) count of less than 200.
The MEC said as a result of the declining headcount in healthcare facilities, community outreach teams are integrating Covid-19, TB, HIV and non-communicable screening and testing during their visits to people’s homes.
She added that call centres were tracking down patients who had defaulted on their course of treatment and appealed to patients to provide healthcare workers with two contact numbers and an address where they could be found.
Simelane-Zulu said the infectious airborne disease, which has a longer incubation period than Covid-19, was causing unnecessary deaths.
“The clock is ticking, because we are losing too many family members and friends unnecessarily, due to TB.
“TB is not only preventable, but it is curable if it is detected early, and if we adhere to treatment,” said the MEC.
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