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South Africa: Officials Under Pressure to Contain Deadly TB

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  • South Africa: Officials Under Pressure to Contain Deadly TB

    South Africa: Officials Under Pressure to Contain Deadly TB

    <TABLE cellSpacing=0 cellPadding=0 width=180 align=right border=0><TBODY><TR><TD></TD><TD align=middle></TD></TR><TR><TD colSpan=2></TD></TR><TR><TD rowSpan=2></TD><TD align=middle><TABLE cellSpacing=0 cellPadding=0 width=180 bgColor=#e8e8ff border=0><TBODY><TR><TD vAlign=top align=left width=10 height=10></TD><TD bgColor=#e8e8ff></TD><TD vAlign=top align=right width=10 height=10></TD></TR><TR><TD bgColor=#e8e8ff> </TD><TD vAlign=top align=left width=160 bgColor=#e8e8ff><!-- left --><!-- text goes here -->

    </TD><TD bgColor=#e8e8ff></TD></TR><TR><TD vAlign=bottom align=left width=10 height=10></TD><TD bgColor=#e8e8ff></TD><TD vAlign=bottom align=right width=10 height=10></TD></TR></TBODY></TABLE></TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE>UN Integrated Regional Information Networks
    September 13, 2006
    Posted to the web September 14, 2006
    Health officials in South Africa are fighting to contain the spread of a deadly, drug-resistant strain of tuberculosis (TB) after an HIV-positive woman with the disease refused treatment and walked out of a Johannesburg hospital.
    Doctors have since located and quarantined the woman, but fear she might have infected several others with extremely drug resistant tuberculosis (XDR TB), a virulent disease that has already killed 52 people in the east-coast province of KwaZulu-Natal.
    "We have collected the women with an ambulance and will seek a court order to get her back into hospital if she again refuses treatment," said Dr Abdul Rahman, chief of operations at Gauteng Province's Department of Health.
    "We will now trace her contacts with hospital staff and members of her family and anyone else, and test them for the XDR tuberculosis strain," he said. "If there are any signs she has spread the disease we will isolate those patients and begin treatment immediately."
    The emergence of XDR tuberculosis has put doctors and health officials on high alert across South Africa, where one in nine of the population is HIV-positive and an estimated 900 die every day from AIDS.
    Medical experts from the World Health Organisation and America's Centres for Disease Control gathered in Johannesburg last week and urged immediate action to fight XDR TB, fearing South Africa's high rates of HIV could speed the spread of the deadly TB through the population.
    All 52 patients killed by XDR TB in KwaZulu-Natal were HIV positive and died within an average of 16 days after diagnosis. Worryingly for the scientific community, all the patients were receiving antiretroviral (ARV) therapy at the time.
    "HIV has the potential to fast track XDR TB into an uncontrollable epidemic," said Dr Karin Weyer, TB Research Director at the South African Medical Research Council (SAMRC). "Infection control precautions are needed now, and must be scaled up without delay in settings where HIV patients are brought together."
    South Africa's Department of Health, lampooned by critics for championing a diet of garlic, lemon and African potato as an alternative treatment for HIV/AIDS, has promised to roll out two powerful antibiotic drugs as early as next week to fight XDR TB.
    "The Department of Health is making progress in ascertaining supply of additional drugs - Capreomycin and Para Amino Salicylic Acid - to deal with extremely drug resistant tuberculosis, with a local company agreeing to provide one of the drugs," the Department of Health said in a statement.
    "These drugs are being reintroduced because of resistance to the first and second line of drugs. There has been no invention of new TB drugs over the past four decades ... The XDR TB strain has resistance to all first-level drugs [used to treat ordinary TB] and it also has resistance to two of the major classes of the second-level drugs used to treat patients with multidrug-resistant [MDR] TB," the department said.
    1.7 Million Deaths Annually
    TB, an airborne disease, spreads much like the common cold through the coughs and sneezes of infected people, killing an estimated 1.7 million people a year around the world, according to the SAMRC. The first symptoms of the illness include weight loss, fever and night sweats. In the advanced stages victims cough up blood. If untreated, TB can kill a patient by gradually boring holes in his lungs.
    TB poses an acute threat in South Africa, where half the adult population has latent TB. It is the most common opportunistic infection in HIV-positive people, and the health system is already strained by huge caseloads of HIV/AIDS. Overcrowded townships, some plagued by Victorian standards of hygiene and sanitation, present an ideal environment for its spread. Only about half the treatable cases are cured.
    <TABLE cellSpacing=0 cellPadding=9 width=180 align=left border=0><TBODY><TR><TD align=right></TD></TR></TBODY></TABLE>Officials at Gauteng's Department of Health called for calm, saying the spread of XDR TB was "neither an epidemic nor a crisis", and they were working to determine whether the XDR found in Johannesburg was the same as the KwaZulu-Natal strain. They would meet with specialists to devise a treatment programme.
    The SAMRC has laid out a seven-point programme to combat the disease, including increased research into anti-TB drugs and promoting universal access to ARVs, while urging the government to set out an emergency plan.

  • #2
    Re: South Africa: Officials Under Pressure to Contain Deadly TB

    <TABLE cellSpacing=0 cellPadding=0 width=622 border=0><TBODY><TR><TD class=twelveblack vAlign=top align=left width="90%">TB woman's family 'fine'
    15/09/2006 12:05 - (SA)
    <!-- Vignette V6 Fri Sep 15 12:08:49 2006 --></TD></TR></TBODY></TABLE>

    Johannesburg - Relatives and others who made contact with the Gauteng woman carrying extreme multi-drug-resistant tuberculosis (XDR-TB) have not contracted the disease, provincial health officials said on Friday.
    "If there was a problem with the woman's family members and individuals she made contact with, the health department would say so," spokesperson Zanele Zungu said.
    The woman, in her 20s, was diagnosed with the disease last Friday at the Sizwe Tropical Disease hospital but refused treatment.
    She then discharged herself and was re-admitted on Wednesday after health officials launched a search for her.
    Immediate family members and individuals who made contact with her were tested on Wednesday for TB, and their progress was to be monitored for the next six months.
    The woman told health officials that when she discharged herself from the Sizwe Hospital in Edenvale, she did not have contact with members of the public, said Zungu.
    "Her partner transported her home and she stayed there until we fetched her".
    On Thursday the health MEC, Brian Hlongwa, visited the hospital and assured the public that the department had the knowledge and resources to deal effectively with the TB strain.
    "There are standard protocols in place to deal with issues of this nature and the department has begun to implement them," said Hlongwa.
    Clinics and hospitals in Gauteng have been instructed to increase their vigilance in the screening and testing of TB patients to ensure early detentions of the MDR-TB, said Zungu.
    Hlongwa urged patients to finish their six-month course of treatment to curb similar cases of TB.
    The XDR form of the disease has claimed at least 50 lives at Tugela Ferry in Kwazulu-Natal since January 2005. XDR-TB is a virulent form of TB which is resistant to the two drugs used to treat multi-drug-resistant TB, and to which people with HIV and Aids are particularly susceptible.,00.html