New Era (Windhoek)

Namibia: Drug Resistant TB Strain Confirmed

Windhoek — After months of suspicions, the Ministry of Health and Social Services on Thursday confirmed the country's first eight cases of extensively drug resistant tuberculosis (XDR-TB), which is resistant to four TB drugs.

Minister of Health and Social Services yesterday announced at a press briefing that of the 291 multi-drug resistant (MDR-TB) cases in the country, eight were found to have progressed further to XDR-TB.

XDR-TB is a severe form of MDR-TB. MDR-TB is resistant against rifampicin and isoniazid while XDR-TB is resistant to these two as well as flouroquinolones and injectable aminoglycosides.

"XDR-TB cases are very difficult to cure but it is not completely impossible," the minister said.

The minister added, "We are dealing with a situation that if not carefully handled might go out of hand."

Yesterday, the minister directed relevant health officials to distribute three drug types available while waiting for other drugs to come from India.

Kamwi confirmed that in the past few weeks, health experts from the World Health Organisation (WHO) and South Africa have been at work in trying to establish the magnitude of XDR-TB in the country.

Two cases of XDR-TB were confirmed in Oshakati, two in Walvis Bay, one in Katima Mulilo, one in Okahao, one in Onandjokwe and one in Outapi.

XDR-TB was diagnosed in people between the ages of 29 and 49.

The minister said the Central Medical Stores has already procured specialised drugs to treat both TB types.

He added that the ministry has consulted with various experts such as WHO, the United States centres for Disease Control (CDC) and the Department of Health in South Africa on how best to manage the situation.

All the confirmed cases are being treated in hospital for careful monitoring on a daily basis.

This is also to ensure that the highly resistant TB strain does not spread to the communities.

"It is the duty of the ministry to keep these patients in our health facilities and to make sure they remain hospitalised in isolation from other patients and the general public," the minister added.

The minister added that family members of the diagnosed eight were already informed about XDR-TB and are under health expert's instructions on how they can communicate with their family members.

The ministry has also started training doctors who will be handling XDR-TB cases.

To prevent TB from progressing to "lethal" XDR-TB, Kamwi says all patients on TB treatment must follow their treatment schedules fully as most XDR-TB cases are a result of defaulting.

Directly Observed Treatment (DOT) through treatment supporters is a highly effective strategy to reduce defaulting. Thus the minister appealed to all Namibians to support those on treatment.

"We intend to strengthen and expand this strategy to all the 13 regions and count on the close cooperation of various community-based organisations (CBOs) and non-governmental organisations (NGOs) and the community at large," the minister said.

Further, the ministry has revised guidelines for management of MDR-TB in an effort to reduce subsequent progression of XDR-TB.

The control measures in TB wards will have to be strengthened in the coming months, the minister said.

"The public will notice soon more stringent measures of infection control in our health institutions to prevent the spread of more serious forms of TB," Kamwi added.

Further, the Government will be renovating and altering some of the main TB wards across the country in order for the facilities to meet the international standards.

Namibia is the second highest in the world in recording TB cases after Swaziland.

The minister early February declared TB in the country a national health emergency.

There were 15771 cases of TB reported in 2006, or about 765 cases per 100000 people. About 1000 cases per 100000 people have been reported in Erongo, Hardap, Karas and Oshikoto.

TB is a new challenge faced by the entire world, WHO country representative Magda Robalo said.

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