7 January 2013

South Africa: Decentralisation of MDR TB Services Yielding Positive Outcomes

press release

The resolve to decentralise Multi Drug Resistance Tuberculosis (MDR TB) expertise to various hospitals in the North West province has started to yield positive outcomes.

Taung hospital in the rural Dr Ruth Segomotsi Mompati district has successfully cured its first MDR TB patient 24 months after decentralisation process has commenced. Ms Selina Kuska of Reivelo in Taung was recently declared cured from the deadly yet treatable condition. Treatment of MDR TB takes 24 months.

Dearth of MDR TB beds due to high demand of the service at Klerksdorp Tshepong hospital complex forced the management of the Department of Health to seek alternative solution to the melting challenge. As a result, the decentralisation of the MDR TB treatment was instituted. Taung hospital together with Gelukspan and Koster hospitals were identified to offer MDR TB services.

While Koster and Gelukspan hospitals MDR TB units are still undergoing some refurbishments to meet decentralisation requirements, the MDR TB unit in Taung was ready for decentralisation. The process was completed in January 2010 and the hospital is now catering as a down referral.

The province has about 96 MDR in-patients including 20 that is currently being managed in Taung and 419 out patients. The MDR cure rate in the province currently stands at 65%.

The province is now experiencing a drop of TB deaths from 8.2% in 2009 to 7.3% and an increase of healing TB patients. The cure rate has improved from 40% in 2008 to 67% in 2011, which is a greater than 25% increase in healing TB patients.

Though the province continues to do well, late reporting of patients to health facilities and patients who continue to default treatment remain a concern.

Defaulter rate is a cause for concern since non-compliance to treatment is the major contributing factor to MDR TB and Extreme Drug Resistant (XDR) TB. Treating MDR/XDR TB is very costly as compared to treating an ordinary TB. This puts a huge strain on the department given the numerous and complex public health challenges it is facing.

- North West Health

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