19 March 2014
Getting to zero TB – tackling HIV and TB drug resistance
World TB Day 2014
World TB Day, on the 24 March, is an opportunity to raise awareness about the burden of tuberculosis (TB) worldwide and the status of TB prevention and control efforts. If we hope to reduce the burden of TB, we need to expand HIV management and detect and treat drug resistant TB early.
There are an estimated half a million new cases of TB in South Africa every year. HIV/AIDS is a major driver of the TB epidemic with high numbers of patients progressing to active disease leading to further exposure and amplifying the risks in an already vulnerable population. However, increasing access to anti-retroviral drugs has been very important in attempting to turn the tide of TB around.
Despite tuberculosis being a curable disease, drug resistant forms of this disease are on the rise globally. South Africa has the fourth highest burden of multidrug resistant TB (MDR TB) globally, with one in 50 people diagnosed with TB likely to develop MDR TB.
MDR TB occurs when people are infected by a strain of TB that is resistant to most available medicines used in the treatment of TB – making treatment more difficult and outcomes worse.
Although the relative proportion of TB patients that develop MDR TB appears to be low in South Africa, the large pool of TB patients means that this small proportion still translates to a large absolute number of more than 10,000 new cases of MDR TB, diagnosed annually. This number is also likely to be an underestimation of the true burden of disease in South Africa.
It should be noted that early appropriate treatment for TB increases treatment success rates and reduces the risk of TB transmission to others. Sadly, the greatest threat for both TB-infected patients and for the uninfected population is patients not taking their medicines as prescribed. This is often as a result of the length of treatment required (six months) and lack of social support networks for these TB patients. The consequence is the development of drug resistance.
TB, and in particular drug resistant TB, remains one of the biggest public health challenges of our time. People with a cough for more than two weeks should go to their clinics to be tested for TB. It is important to note that the infectious risk of TB cases drops dramatically when they are placed on effective appropriate treatment. In addition, people are strongly encouraged to know their HIV status as early diagnosis and appropriate preventive treatment will significantly reduce their risk for TB.
For further information please contact Nombuso Shabalala on 011 555 0545 or email email@example.com
The National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service,