City Comes Knocking For TB

City Health is literally going door to door to increase testing rates for tuberculosis (TB) in a bid to drive down the number of people affected. Read more below:

The City of Cape Town’s Health Department is intensifying its outreach campaigns during TB Awareness Month in a bid to test more people for TB. This includes a door-to-door campaign to educate the public about TB and the importance of regular testing for high-risk individuals.

Recently, Statistics South Africa revealed that TB killed more than 33 000 people in 2015 and that it has remained the leading cause of death for many South Africans in the past three years. Nationally, the TB incidence rate is 520 per 100 000 of the population. However, the Eastern Cape (692), Kwazulu Natal (685) and Western Cape (681) buck the trend.

‘The statistics are unfortunate because TB can be successfully treated. The most vulnerable groups are people living with HIV and diabetes, household contacts of people with TB, pregnant women, and children under the age of five. There are a range of health and socio-economic factors that come into play and bedevil efforts to fight TB,’ said the City’s Mayoral Committee Member for Safety and Security; and Social Services, Alderman JP Smith.

The treatment of drug-resistant TB continues to be a concern, although the City of Cape Town has made steady progress in speeding up the diagnosis of cases and improving the treatment success rate. There has been a decrease in the number of multi-drug resistant and extreme drug resistant cases since 2014, believed to be linked to two key interventions:
• The reduction in the turnaround time between diagnosis and treatment from 36 days in 2010 to an average of seven days in 2016
• An increase in the number of drug-resistant patients who are treated in the community (77% in 2009 to 91% in 2016), making it easier for them to comply with treatment. Nationally, the Cape metro leads the way for decentralising drug-resistant TB to primary healthcare level, facilitating access to care

Another plus is the percentage of TB patients whose HIV status is also known. This means that patients can be treated effectively for the two conditions and so improve their chances of recovery.

In spite of the successes, there are a number of challenges that remain, including the percentage of drug-resistant TB patients who default on their treatment as a result of the length of treatment and side-effects brought on by the various medications they have to take. It is hoped that the introduction later this year of a shortened treatment regimen, approved by the World Health Organisation, will help improve the situation.

Another challenge is that people are not taking TB seriously enough to be tested whenever they have a productive cough or come into close contact with a TB patient. It is for this reason that City Health is increasing its outreach programmes to target adults and also raise awareness about the importance of screening children who are exposed to TB in the home.

Currently South Africa subscribes to the 90:90:90 Strategy – the aim being to screen 90% of people in the key populations for TB, starting 90% of those diagnosed on treatment, and ensuring that 90% of those started on treatment successfully complete it. In addition, a national TB prevalence survey set to get under way this year will help to inform the strategy of the national TB programme.

‘We have made gains in the fight against TB, but the reality is that it is a shared responsibility. We cannot treat patients if they go undiagnosed. Nor can we force patients to adhere to the treatment regimen. So I appeal to the public to work with us and help spread the message about the importance of testing and seeking treatment,’ said Alderman Smith.

The City will be hosting a number of outreach, awareness, and testing events to mark World TB Day on Friday 24 March 2017. A list of planned activities is contained in the link here: http://tinyurl.com/zylwojs

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