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TB in SA
Posted by Death



SA: 700 NEW TUBERCULOSIS CASES A MONTH IN THREE EC HOSPITALS
Date Posted: Sunday 02-Sep-2007

September 1 2007 -- PORT ELIZABETH, South Africa. Hospitals in South Africa's Eastern
Cape province are grappling with increasing numbers of tuberculosis cases, with about
250 new patients each being admitted to Livingstone- and Dora Nginza hospitals each
month. The province also has the country's lowest TB-cure rates with more than 200
new multi-drug resistant Tuberculosis patients being admitted from throughout the
province to the Jose Pearson specialist-TB Hospital in Bethelsdorp each month,
according to the Port Elizabeth Hospital Complex' chief executive officer Lulamile
JamJam. Adding it all up, this amounts to 700 new TB cases being identified in one
province of SA alone. And those are the 'official' government statistics.

The Herald Online, published in Port Elizabeth, reported that local TB control
specialists issued public appeals to local businesses to 'prioritise TB in the
workplace' during an unappetising-sounding event referred to as a 'TB-breakfast
meeting' here this week.

TB-HIV co-infection rates are high in SA, with as many as 60 percent of all adult TB
patients also being HIV-positive in South Africa. This means that Multidrug-resistant
TB is beginning to get a free reign because the normal TB-treatments are no longer
effective. This developing drug-resistant Tuberculosis+Aids infection rate can be
seen by the fact that the Medical Research Council of South Africa already found five
years ago that 1.6 percent of all the new TB cases and 6.7 percent of all the
re-treatment cases had multiple-drug-resistant Tuberculosis.

The country now has many patients dying of extremely-drug-resistant Tuberculosis, but
the exact number of XDR-TB deaths is not known: the latest available "official"
health department statistics were published in February this year, and then stood at
more than 600 XDR-TB deaths countrywide. Now, with 700 new TB cases being identified
in one province of SA alone, these statistics have undoubtedly been raised
dramatically since that time.

Lowest TB-cure rate in the country:

One way in which XDR-TB deaths can be measured is by the TB-cure rates, which in the
Eastern Cape province ranks second countrywide.
It's ominous that the Eastern Cape has the highest number of new TB patients being
referred to hospitals but also has the lowest TB-cure rate recorded countrywide.

"TB is a critical public health problem, but it is also a social issue. We will not
get this epidemic under control without strengthening our health systems," claimed Dr
Lindiwe Mvusi, head of the national TB control programme.

340,000 new TB cases in 2004:

In 2006, the World Health Organization ranked South Africa fifth among the world's 22
high-burden TB countries. WHO's Global TB Report 2006 notes that South Africa had
340,000 new TB cases in 2004, with an incidence rate of 718 cases per 100,000
people - more than doubling the 338 per 100,000 in 1998.

TB-HIV co-infection rates are high, with as many as 60 percent of adult TB patients
being HIV-positive. Multidrug-resistant TB is also soaring: the Medical Research
Council of South Africa already found in 2002 that 1.6 percent of all the new TB
cases and 6.7 percent of all the re-treatment cases had multiple-drug-resistant
Tuberculosis.

LINKS:

USAID: TB gets $1.6-m annually, AIDS $5-m annually:
Between 2000 and 2005, USAID funds for TB treatment in South Africa averaged $1.6
million per year.

Please note their budget justifications, in which they claim that 'deep economic and
social fissures from the apartheid era persist..."
links

http://www.usaid.gov/policy/budget/c...a_complete.pdf

http://www.usaid.gov/policy/budget/c.../za674-008.pdf

http://www.usaid.gov/our_work/global...a_profile.html

University Research Corporation:
LINK:
http://www.urc-chs.com/

http://www.usaid.gov/our_work/global...a_profile.html

Sapa report on Eastern Cape new TB-infections Sept 1 2007:
http://www.int.iol.co.za/index.php?s...2317413C272184


Posted by Mister Superstar


Death wrote...
Another way to get it under control is quarantining TB patients, which is even
more expensive than treating them. Throwing money at the problem isn't the
solution, because every new TB patient is used to justify a budget increase,
so it provides a negative incentive to prevent the spread of TB. A better way
would be to make it clear to everyone in the TB field that their budgets are
strictly fixed and that NO increases in funding will occur and that their job
is to use the existing funds to treat existing TB patients and prevent new TB
infections. Salaries are also fixed, with bonuses being a share of the budget
money left over at the end of the year. If they fail to contain the disease,
they will spend the entire budget on expensive TB treatment and get no bonuses.
Exactly the opposite of what is occuring now with both TB and HIV.