Issued by: Department of Health
Johannesburg - In the run-up to World TB Day on 24 March 1997, Director-General of Health, Dr Olive Shisana today released a startling new report on the tuberculosis epidemic, entitled TB in South Africa: The People's Plague. This is the first comprehensive report ever formally published by the Department of Health on TB.
The new report details the seriousness of the TB epidemic in South Africa and the causes of TB sickness and spread in this country. South Africa is facing a massive, and growing, TB epidemic, which will destroy countless families, take thousands of lives, and cost millions of rands in the years to come. In releasing the new report, the National Department of Health is sounding the call for all health workers to adopt the DOTS strategy to cure TB over the next several years. DOTS stands for Directly Observed Treatment, Short-course.
"We are releasing this report to raise awareness of the severity of TB in this country and to indicate our commitment to TB, which is the biggest infectious killer in South Africa," said Dr Refiloe Matjie, Manager of the National TB Control Programme. "If treatment programmes are not improved now, the number of annual TB cases will quadruple over the next ten years."
TB treatment is currently available at all clinics and hospitals, but the new DOTS strategy is not yet in place countrywide. COmplete coverage of the country with DOTS is not expected until the year 2000. Progress towards implementing DOTS includes: strengthened TB management at national, provincial, regional and district levels; the identification of demonstration and training districts around the country; and the training of several thousand health workers in the DOTS strategy, which will strengthen existing services and ensure the cure of many more TB patients.
The DOTS strategy is a health care management approach which provides support to TB patients by observing them as they swallow their TB drugs and ensuring that they complete treatment. Other components of DOTS include the appointment of TB managers, training of health staff, the use of microscopes to detect TB bacteria, and monitoring of the patients throughout the treatment process.
The TB epidemic in South Africa has been documented as one of the worst in the world. At the current pace of the epidemic, nearly one out of every twelve South Africans will become sick with TB in the next ten years. Nearly two-thirds of the population is estimated to be infected with TB. About ten thousand people die of TB every year.
TB spread when people cough TB bacteria into the air, and others breathe them in. When one person is sick with TB, and not properly treated, that person will likely infect ten to fifteen others every year. Three and a half million new TB cases are expected by 2005 if current trends continue.
The TB epidemic is worsened by the development of a new, deadlier form of TB. This is multidrug-resistant TB, which develops when patients begin, but do not finish, their six month course of TB medication. Two thousand South Africans developed multidrug-resistant TB just last year, and most will die from it.
The rapid rise of HIV in this country is also accelerating the spread of TB within the community, and causing more people to become sick with TB.
Although TB is nearly 100 percent curable, only about half of the TB patients in this country are being cured. The Department of Health, in collaboration with non-governmental groups, hopes to improve cure rates nationally to at least 85 percent of newly identified infectious patients by the year 2000 by implementing DOTS.
"With DOTS", explained Dr Matji, "you prevent multidrug-resistant TB, you cure TB patients the first time around, you treat TB effectively in HIV-positive people, and you prevent the spread of TB to the community. In addition, you use your resources in the wisest way possible."
People should get to their nearest clinic if they have been coughing for three weeks or more, experiencing fever and night sweats, and losing weight. Community members can support other people in helping them to complete their treatment.
No=governmental organisations (NGOs), such as the South African National TB Association (SANTS) and the Western Cape TB Alliance, are powerful partners in the effort to fight TB in the community. Cooperation between the government and NGOs will be essential in linking health service staff to patients, families and communities, and thus curing more TB patients.