Bay losing the war against tuberculosis

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NELSON Mandela Bay is losing the war on tuberculosis, with less than a third of infected patients recovering from the disease.

This is way behind the national cure rate of 68% and the World Health Organisation’s expectation of 85%.

A shortage of community nurses and stock is leading to a spiralling rate of patients defaulting on their medication and developing drug-resistant strains of the disease.

The city also has a massive shortage of beds to treat the disease, with the TB hospitals Jose Pearson, Empilweni and Uitenhage’s Orsmond providing 761 beds in all.

This is despite the case finding last year by the Health Department that 11830 Bay residents suffered from TB.

The three TB hospitals have a combined 2010/11 budget of R138-million, a jump from R81-million in 2009/10.

Many patients infected with TB, multidrug-resistant (MDR) TB and extreme drug-resistant (XDR) TB, who spoke to The Herald, said they had been misdiagnosed by nurses at the city’s primary healthcare clinics.

Only when many were too frail to walk did private doctors test them for TB and send them for treatment.

According to a recent district health report, which The Herald has seen, the city is struggling with:

High rates of TB patients defaulting on treatment, which the department said was 11% in 2009;

• A shortage of MDR TB beds and a long waiting list for admission, although the department denied this, saying there was a "community-based management for MDR-TB” in place;
• A less-than 30% success rate with treating TB;
• Poor infection control in health facilities; and
• A high death rate among coinfected patients, also suffering from diseases like HIV and Aids.

A team from The Herald visited Jose Pearson, in the Greenbushes area, and found that XDR and MDR patients mingled freely with one another, despite medical research showing that cohabiting of MDR and XDR patients causes deadly strains of the disease.

Bay health directorate head Dr Mamisa Chabula-Nxiweni said nurses were supposed to counsel patients and explain the process of taking their medication.

Dr Martie van der Walt, of the Medical Research Council, said the government needed to improve ways of identifying TB sufferers.