8 January 2013

South Africa: North West Making Inroads in Fight Against MDR TB

Pretoria — The North West Health Department's move to make Multi Drug Resistant Tuberculosis (MDR TB) expertise available at various provincial hospitals is starting to bear positive results, with the province recording a significant drop in the number of TB deaths.

"The province is now experiencing a drop of TB deaths from 8.2% in 2009 to 7.3% in 2011 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," the provincial Health Department said in a statement.

The department's achievements include the Taung Hospital in the rural Dr Ruth Segomotsi Mompati District, which successfully cured its first MDR TB patient, Selina Kuska, 24 months after the much needed expertise were made available at various provincial hospitals.

Kuska, from Reivelo in Taung, was recently declared cured from the deadly yet treatable condition. MDR TB treatment takes 24 months.

Department spokesperson Tebogo Lekgethwane said the shortage of MDR TB beds due to the high demand for the service at Klerksdorp Tshepong Hospital complex forced the management of the department to seek alternative solutions to the challenge. As a result, the decentralisation of MDR TB treatment was instituted in 2010.

"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 [serving] as a down referral," said Lekgethwane.

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

Though the province continues to do well, Lekgethwane said that the late reporting of patients to health facilities and patients who continued to default treatment remained a concern.

"The 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 compared to treating ordinary TB. This puts a huge strain on the department, given the numerous and complex public health challenges it is facing," he said.

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