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Quarantine Orders for XDR-TB Patients
Business Day (Johannesburg)
NEWS
October 25, 2006
Posted to the web October 25, 2006
By Tamar Kahn
Cape Town
Health authorities would use their legal powers to quarantine patients with extremely drug-resistant tuberculosis (XDR-TB) who refused to stay in hospital and comply with treatment, health department director-general Thami Mseleku told Parliament yesterday.
"We will ask for court orders (for quarantining patients) if need be," he said.
Patients would be released when their disease was under control (making them less infectious), provided they agreed to complete their course of medication, he said.
The recent emergence of XDR-TB in SA has alarmed public health experts around the world, as it appears to pose a particularly high risk to people infected with HIV.
All of the 78 confirmed cases in KwaZulu-Natal, 74 of which have so far proved fatal, tested positive for HIV, said Mseleku.
More than 5,5-million South Africans are living with HIV, according to government figures.
There is no evidence so far that XDR-TB is any more infectious than ordinary TB.
Documents presented in Parliament yesterday detailed low cure rates (51%) for ordinary TB, and even lower rates for multi-drug-resistant MDR-TB (23%). The papers also highlighted problems in handling patients with MDR-TB, which is resistant to first-line treatment drugs rifampicin and isoniazid.
Often patients with MDR-TB discharge themselves from hospital or stop taking their pills -- due to drug or alcohol abuse problems, or because they suffer side-effects.
The latest strain of TB to emerge in SA, XDR-TB, does not respond to first-line drugs and is also resistant to at least three of the six classes of second-line drugs. It is tackled with older, less effective drugs, such as capreomycin and para amino salicylic acid.
Mseleku said doctors could obtain a court order to confine infectious patients to hospital in the interests of public health, but this was considered a measure of last resort. He said more emphasis needed to be placed on raising public awareness of the dangers of not completing the standard six-month course of antibiotics for combating ordinary TB, as failure to do so increased the risk that patients would develop drug resistance.
Patients infected with such drug-resistant strains could transmit the disease to other people by sneezing or coughing, thus posing a public health threat.
"If people develop resistance to those drugs (capreomycin and para amino salicylic acid), nothing else is left," said Mseleku, noting that the new TB drugs were not expected to reach the market before 2015.
Copyright ? 2006 Business Day. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).
Business Day (Johannesburg)
NEWS
October 25, 2006
Posted to the web October 25, 2006
By Tamar Kahn
Cape Town
Health authorities would use their legal powers to quarantine patients with extremely drug-resistant tuberculosis (XDR-TB) who refused to stay in hospital and comply with treatment, health department director-general Thami Mseleku told Parliament yesterday.
"We will ask for court orders (for quarantining patients) if need be," he said.
Patients would be released when their disease was under control (making them less infectious), provided they agreed to complete their course of medication, he said.
The recent emergence of XDR-TB in SA has alarmed public health experts around the world, as it appears to pose a particularly high risk to people infected with HIV.
All of the 78 confirmed cases in KwaZulu-Natal, 74 of which have so far proved fatal, tested positive for HIV, said Mseleku.
More than 5,5-million South Africans are living with HIV, according to government figures.
There is no evidence so far that XDR-TB is any more infectious than ordinary TB.
Documents presented in Parliament yesterday detailed low cure rates (51%) for ordinary TB, and even lower rates for multi-drug-resistant MDR-TB (23%). The papers also highlighted problems in handling patients with MDR-TB, which is resistant to first-line treatment drugs rifampicin and isoniazid.
Often patients with MDR-TB discharge themselves from hospital or stop taking their pills -- due to drug or alcohol abuse problems, or because they suffer side-effects.
The latest strain of TB to emerge in SA, XDR-TB, does not respond to first-line drugs and is also resistant to at least three of the six classes of second-line drugs. It is tackled with older, less effective drugs, such as capreomycin and para amino salicylic acid.
Mseleku said doctors could obtain a court order to confine infectious patients to hospital in the interests of public health, but this was considered a measure of last resort. He said more emphasis needed to be placed on raising public awareness of the dangers of not completing the standard six-month course of antibiotics for combating ordinary TB, as failure to do so increased the risk that patients would develop drug resistance.
Patients infected with such drug-resistant strains could transmit the disease to other people by sneezing or coughing, thus posing a public health threat.
"If people develop resistance to those drugs (capreomycin and para amino salicylic acid), nothing else is left," said Mseleku, noting that the new TB drugs were not expected to reach the market before 2015.
Copyright ? 2006 Business Day. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).
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