Issued by: Department Of Health
JOHANNESBURG - Today the Director General of Health, Dr Ayanda Ntsaluba joined the South African National Tuberculosis Association (SANTA), the Medical Research Council (MRC) and a TB patient to renew their commitment to the DOTS strategy to stop TB in South Africa. A new TB publication called the "Faces of TB" was also released.
This event was held as part of an international commemoration of World TB Day, to launch a new campaign Stop TB Use DOTS.
Dr Ntsaluba, said in his address "With a 107 000 TB cases reported in South Africa in 1997 and 10 000 deaths annually, the TB epidemic is still alarming. TB is a serious problem and the Department of Health has made TB control a priority and committed its resources to the implementation of the internationally renowned Directly Observed Treatment Short-course (DOTS) strategy."
DOTS focusses on cure infections TB patients so as to stop the spread of TB at its source. Because TB takes at least six months of treatment to be cured, DOTS advocates that TB patients are directly observed and supported to take their TB medication every day until they are cured. TB treatment supporters can be health workers, employers or any responsible community
The Department of Health has implemented the DOTS strategy in 63 pilot DOTS districts and is planning to expand these to 114 districts by the end of 1999. This will ensure that two thirds of the country is covered by DOTS.
"Subsequent to recommendations made by the World Health Organisation, which declared South Africa as having one of the worst TB epidemics in the world, we have improved our TB laboratory services to ensure that infectious TB patients are diagnosed efficiently and are started on treatment timeously. By training 5000 health workers on the DOTS strategy, we have ensured that all DOTS pilot districts have staff who are trained on the DOTS strategy. Our reporting and recording system has improved and we are able to monitor TB patients and their progress until a proofed cure has been documented," said Dr Ntsaluba.
He also congratulated SANTA on its efforts in managing TB. Many TB patients are very ill and still need the hospitalisation facilities that SANTA offers. He urged non governmental organisations, communities and employers to take the lead in mobilising volunteers to assist in observing and supporting TB patients at their places of work or communities.
Dr Andrew Ratsela, the incoming SANTA chief executive officer reflected his commitment in his statement, saying "I am determined to work alongside all key stakeholders in developing a well intergrated and efficient network of DOTS treatment supporters to deliver DOTS on the ground."
He said that although the Department of Health is strengthening its TB management services, the TB burden continues to grow because of the escalating HIV/AIDS epidemic, high percentages of patients who do not complete their TB treatment and the rising cases of drug resistant TB patients. Annually there are 2000 new TB patients resistent to some of the key TB drugs and have developed multi drug resistant (MDR)TB. The drugs for treating a single MDR-TB patient is R25 000 compared to the R250 for drugs to treat a new TB patient.
According to Dr Ratsela SANTA's commitment to an efficient DOTS network is the right step to ensuring treatment completion and decrease in MDR-TB development. SANTA has a good volunteer base supporting TB patients. TB patients do not have to stay in hospital for long periods and this has created more space for SANTA hospitals to accommodate sick TB patients and to deliver a better service. Dr Ratsela warned that SANTA needs to mobilise for more resources to better achieve as it currently competes with other NGOS in South Africa for limited resources.
"40% of TB cases are attributable to the presence of HIV," added Dr Ntsaluba. The presence of HIV lowers the body's ability to fight diseases making those who are HIV positive vulnerable to developing active TB. Two thirds of South Africans are infected with the TB germ but the majority will never get sick with TB. However, those who are also infected with HIV are likely to get sick with TB.
"Both the TB and the HIV/AIDS programmes are collaborating so as to find an urgent solution to address the dual epidemic."
On the release of the third annual TB advocacy publication. "Faces of TB" Dr Matji had this to say. "For the first time the experiences of health workers and TB patients have been compiled to show the lessons we have learnt in the first two years of the implementation of the DOTS strategy in South Africa".
Dr Ntsaluba added that, "The personal accounts in "Faces of TB", show that TB is not just about diagnoses and medication, it is a real disease that affects people in all spheres of their lives, TB is curable, but for those who interrupt, treatment it becomes a life battle and a struggle for themselves, their families, communities and may eventually take their lives."
He urged journalists to join the Department of Health and SANTA in intensifying efforts to helpstop TB by making TB visible and advocating for a commitment to the DOTS strategy.
Date 19 March 1999
Contact Ntombekhaya Matsha
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Jacqui van Rensburg
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