24 March 2011
South Africa – with only 0.7% of the world’s population – has the third-highest TB burden in the world.
The most important factor in the resurgence of TB in this country over the past 20 years is HIV/AIDS. These two diseases form a lethal combination, with each speeding the other’s progress. No less than 73% of South African TB patients are co-infected with HIV; 28% of global HIV-positive TB cases can be found in this country.
This is why Health Minister Dr Aaron Motsoaledi last year declared HIV/AIDS and TB to be the biggest and most devastating disease pattern in South Africa, and introduced actions to address them.
Chief among these interventions is the HIV Counselling and Testing (HCT) campaign, which aims to test 15-million South Africans for HIV by June this year. Added to the HCT campaign is a further initiative, intensified case-finding (ICF), which involves teams of health workers going door-to-door to get people to test for HIV and TB.
Today, World TB Day, sees another innovation being introduced by the Minister: GeneXpert, a TB testing method with a turnaround time of only two hours – a vast improvement on the 24-48 hour sputum test, and the six weeks that a TB culture test requires. The GeneXpert is able to analyse 200 sputum samples in one cycle.
“One of the most critical elements to combating these two killer diseases is, simply, knowledge. The more we know about HIV/AIDS and TB prevalence and distribution, the more able we are to make timely, appropriate and effective interventions,” says Motsoaledi.
“As much as we have for years called on people to know their own HIV status, so the State must have an accurate picture of the situation. This is exactly why we launched the HCT and ICF initiatives – we must know what is really happening in our communities before we can act decisively.”
But, says Motsoaledi, a critical challenge is the turnaround time for testing, between when people provide their sputum samples to when they receive their results.
“Even a 24-hour turnaround can be problematic, in terms of reporting the results back to people. GeneXpert can literally determine a person’s TB status while they wait, and it is set to revolutionise the way we do TB testing,” says Motsoaledi, at the unveiling of the GeneXpert technology at Prince Mshiyeni Hospital in Umlazi, outside Durban.
Dr Siphiwe Mndaweni, of the University Research Co. LLC, a partner in government’s Stop TB campaign and a participant in ICF, says that it is of utmost importance that people with active (infectious) TB are traced as soon as possible and afforded the appropriate medical treatment.
“One person with active TB can infect around 15 people every year. So the sooner we can identify TB cases in communities, and which communities are the hardest-hit by the disease, the more people can be treated, and the more fresh TB cases can be avoided.
According to Dr Mndaweni, the perception that HIV-positive people who contract TB cannot be cured of the latter disease, is mistaken.
“HIV-positive people can be, and are, cured of TB. What is most important is that they finish their entire six-month course of antibiotic TB medication, even after they start feeling better, in order to completely eradicate the TB bacterium in their bodies.
“If they fail to complete their course of medication, they are at high risk of developing multi-drug resistant TB (MDR-TB) or worse, extensively drug-resistant TB (XDR-TB). MDR-TB is much more difficult to cure, and XDR-TB is fatal in virtually all cases,” says Mndaweni.
Issued by Marcus Brewster Publicity on behalf of Johns Hopkins Health and Education in SA (JHHESA).
For further information, please contact Ramona Baijnath from the National Department of Health TB Cluster on 082 0668899.