/ 12 September 2006

SA prepares to combat super TB

South Africa’s Department of Health has promised to start distribution as early as next week of a drug to help fight an extremely virulent strain of tuberculosis (TB) that has killed 52 people in the country.

However, the government warned on Tuesday there was no guarantee the drug will save lives as it may prove ineffective against the new superbug, which threatens to exacerbate South Africa’s HIV/Aids crisis.

”We don’t have many drugs for TB to choose from simply because no major new inventions have been made for the past few decades,” said Charity Bhengu, department spokesperson.

On the advice of medical experts, the Department of Health has signed a deal with local pharmaceutical company Aspen to buy Capreomycin and talks are under way with a second supplier to secure Para Amino Salicylic Acid.

The two antibiotics increase the pool of treatment combinations available for those suffering from TB in South Africa, although the drugs have been widely available in other nations for years.

In South Africa, the only test of whether the drugs can end or cure a highly drug-resistant strain is to wait and see the response by patients, a process that could take months.

XDR-TB (extremely drug resistant-TB) is a strain of tuberculosis that is resistant to at least two primary drugs and three or more second-line drugs.

”Wherever [the strain] is identified they will have access to the drugs. It’s not a matter of whether we can afford it or not. The money is there,” said Bhengu.

The price tag will be known once provincial governments determine what is required to stock hospitals and clinics, she said.

TB is an airborne illness — spread through coughing and sneezing — that is especially deadly for those with immune systems weakened by HIV.

The virus that causes Aids affects nearly one in nine South Africans, making it one of the highest caseloads in the world.

In South Africa’s eastern KwaZulu-Natal region, 53 people have been diagnosed with the highly virulent strain of TB. Of those, 52 have died and all those tested for HIV were positive.

Dr Tony Moll, who detected the disease at King George Hospital in Durban, has called for the two extra medications as part of a comprehensive strategy to control the outbreak but added the first priority should be a nationwide tally of cases.

”I think number one is to do surveillance across the country and find out how big the problem is,” Moll said.

Endemic

The Mercury reported on Monday that XDR-TB has become endemic in KwaZulu-Natal.

Moll, principal medical officer at the Church of Scotland hospital in Tugela Ferry, said doctors in his area had been identifying new XDR-TB patients every month since January last year.

”Since March we have identified 10 new patients. The situation seems to be simmering, it’s a bad sign,” he said.

”What’s more worrying is that this has spread across the province and has become endemic to the province.”

”Between 2002 and 2004, 347 patients throughout the world were identified with XDR-TB, and for us in a small rural area to have [so many] die is very significant.” –Reuters and Sapa