New approaches and tools in dealing with multidrug-resistant tuberculosis (MDR-TB) must be sought, the South African branch of international medical humanitarian organisation Médecins sans Frontières (MSF) said on Friday.
”MDR and now [extensively-drug resistant] TB are the tip of an iceberg of failing strategies to control TB,” the organisation said in a statement released to commemorate World TB Day on Saturday.
MSF said MDR-TB needed to be dealt with in a way that took into account the particularities of the South African context.
The challenges of fighting drug-resistant TB in this country were radically different from places such as Eastern Europe, which had a lot of experience in fighting the pandemic.
In South Africa there were ”much larger numbers of MDR-TB patients to treat”, said MSF’s South Africa head Dr Eric Goemaere.
”An overwhelming majority are HIV-TB co-infected, and the infrastructure limitations make highly centralised, hospital-based care impractical.”
MSF estimated that in an area such as Khayelitsha in Cape Town, where it is supporting government HIV/Aids and TB programmes, one in 50 people developed active TB every year.
Of these 67% were HIV positive.
MSF said at the moment it took about two months to diagnose MDR-TB, and even after diagnosis, patients could wait up to four months for a hospital bed.
Western Cape department of health statistics showed that of those MDR-TB patients that did get treatment, 38% stopped treatment before it was finished because it took too long, the side effects of the drugs were harsh and patients were confined to hospital for four months.
The MSF said it condemned the Gauteng health department’s ”forcible detention” this week of 13 MDR-TB patients, saying it was not a viable solution in the face of the overwhelmed state of TB services in the country.
On Tuesday, the Gauteng health department obtained a court order to the effect that 13 MDR-TB patients, who had tried to escape from a Pretoria hospital and be admitted as outpatients at another hospital, should be forced to stay as in-patients. — Sapa