Tuberculosis

The terrible reality is South Africa has one of the highest burdens of Tuberculosis (TB) in the world with the World Health Organisation reporting that about 1% of the 50 million population have active TB each year. But strategic objectives are in place and being monitored to reduce this burden:

  • To strength infection control
  • To address the TB and HIV, MDR and XDR-TB
  • To co-ordinate and implement TB research
  • To contribute to health systems strengthening
  • To strength and implement access to medication and care for the infected

Having TB is not a death sentence. Screening, testing and treating can ensure TB is cured and not spread.

Simple and easy screening

Five simple questions is all it takes

At the facilities we run or support we implement the World Health Organisations guidelines for screening for TB with an answer to 5 basic questions we can determine the best approach.

  • Have you been around anyone who has been diagnosed with TB?
  • Have you had a cough for more than three weeks?
  • Have you had any unexplained weight lose?
  • Do you heavy night sweats?
  • Are you extremely tired or fatigued?

Answering yes to these questions indicates that a visit needs to be made to a local clinic for further tests. We currently screen 93% of patients using this simple method.

Front line diagnosis of tuberculosis

The traditional methods are no longer working

To speed up diagnosis of tuberculosis we realised that the smear test (sputum microscopy) which requires samples to be collected in a specially built isolated couching area and sent to a laboratory for culturing was not satisfactory. We needed quicker results and the ability to identify complicated TB like multi-drug resistant TB.

GeneXpert ™ rollout

With a turnaround time of under 2 hours this rapid test can simultaneously identify Mycobacterium TB and resistance to rifampicin (RIF), a common first-line drug for treatment of the disease and a reliable surrogate marker of multidrug-resistance. We spear headed the use of the technology in both the public sector and laboratory services in South Africa. These types of tests are also a common sight within our clinics.

X-ray diagnostics

To optimise a common tool used to diagnose TB, we realised we needed to accelerate the process the abnormality identification. Digitising x-rays, storing them in a central database and automating their review with computer aided diagnosis technology and analysed by qualified radiologists increased our capacity. The innovative mobile x-ray trucks programme is reaching geographically disturbs patients within South Africa who would ordinarily not have access to these services.

Managing co-infected patients

It is estimated that 60% of people with tuberculosis also have HIV. Over five years ago we realised the importance of educating health care staff and enabling the use INH preventative therapy (IPT). This method of preventive care has shown to have results. In keeping with the national average we screen over three quarters of our HIV positive patients within our care and review there need to for IPT treatment.

The care does not stop there

We never stop and continue to look for solutions and areas where we can provide assistance. We are concentrating on:

  • TB is children with a diagnostic challenge and we are reinforcing best practices at all our supported facilities and are validating newer diagnostic tests for this vulnerable group.
  • Building capacity to diagnose and manage Multidrug and Extensively Drug-Resistant TB (M/XDR-TB).
  • Operating TB Focal Points to ensure that any patient suspected of having TB is investigated appropriately and sputum induction facility built to improve testing rates.