WORLD TB DAY - DOTS CURE FOR ALL

22 March 2001

In spite of the fact that Tuberculosis is a curable disease we seem to be losing our battle against it.

• Last year, 1 529 people in Gauteng died from TB. That means about five people a day died of TB last year in Gauteng.
• The number of new infectious cases diagnosed during the year was close to 12 138.

We are steadily improving our rate of cure for TB in Gauteng, but both the number of deaths and the number of new infections are up on the previous year. This means that, despite improvements in treatment, we are not yet moving strongly and rapidly enough to send this deadly epidemic into reverse.

Saturday March 24 is World TB Day: It is an Opportunity to increase awareness about TB and mobilise against this deadly - but curable -disease. The theme for the year is 'DOTS cure for all' with a special focus on fighting TB in the workplace.

As with the HIV/AIDS pandemic, the question of partnerships is critical to the battle against TB. It is not an epidemic that will be conquered in the confines of our clinics. Public awareness and an intersectoral support network are the vital ingredients that must be added to medical expertise.

What can members of the public do?

Be alert, know the signs

• The signs of TB are persistent cough - which lasts more than three or four weeks and is often (but not always) painful -combined with loss of weight and night sweats. Blood will not necessarily be seen in the sputum and anyone who suspects they have TB should not wait for this sign to seek help.
• If you know someone with these symptoms, share the information and encourage him or her to seek help.

Seek help early

• Delays in seeking help may cause a deterioration that makes treatment more costly and more difficult.
• Furthermore, undetected TB is a threat to us all. TB is transmitted when an infected person coughs or sneezes while in close proximity to others. The potential to transmit TB in domestic situations, the school, the work place or in settings like hostels and prisons is therefore quite high. But once someone with TB is taking treatment, he or she can no longer infect others.

Know where to go

• Most municipal and provincial clinics offer testing and treat for tuberculosis.
• The test is free and it is painless - involving the taking of a simple sputum sample. In Gauteng we can give result within two days.
• Treatment is also free. In advanced cases it may involve a short period in hospital, but mostly this is not the case. It will certainly involve taking a combination of tablets daily for six to eight months.

Build support systems

• Individual being treated for TB simply stop taking their pills in about 15% of cases and this seriously undermines our cure rates. Retreatment is more expensive - and it doesn't always work. People with TB may "drop out" before taking the full six to eight months of medication for a variety of reasons:
• The client begins to feel better after a few weeks and concludes - wrongly - that he or she is "cured".
• Unpleasant side-effects develop and the client is discouraged.
• Fetching medication may conflict with the client's work, study or domestic responsibilities.
• To reduce drop-out rates, our health services attempt to secure a dedicated treatment supporter for each patient- usually someone who is not a professional health worker, but a lay volunteer. His/her is to administer the daily medication, to educate and counsel the client and encourage course completion. Treatment supporter must be located for easy access- in the workplace, the school, the neighbourhood.
• Our clinics have hundreds of treatment supporters but constantly on the look out for more volunteers to provide a more convenient service for the client. We provide the necessary training for volunteers to do the job with confidence.

Is the HIV/AIDS epidemic behind the rise in TB?

A person who is HIV-positive will over time have reduced ability to fight infections. Therefore, if exposed to infectious tuberculosis, he or she is considerably more likely to contract the disease. Given our high rate of HIV, we can predict that the number of new TB infections will increase sharply in the years to come.

However, successful treatment of TB is still achievable in the overwhelming majority of cases where it co-exists with the HIV virus. It is therefore still possible to improve our present cure rates for TB in the face of the HIV/AIDS epidemic.

HIV and TB are an explosive combination. But we cannot throw up our hands in despair. We need to appreciate just how serious the situation is and get a firm grip on TB now while there is a window - a very narrow window - of opportunity to do so.

Gauteng Health Department is holding various TB awareness events in communities this week.

• On Friday March 23, there will be an event at Kempton Park Civic Centre targeting private sector.
• Door-to-door campaigns in Orange Farm/Lakeside/Graceland, F Netown, Hopistal Hill, Thulamtwana.

These are but a few events taking place on the World TB Day.
There are about 40 more other events.

Issued by: Gauteng Health Department

Inquiries to:
Dr Rianna Louw, TB Programme Coordinator
O82-757-0733
Popo Maja; Head of Communications