SA: XDR-TB will explode as full-blown epidemic due to government inaction

[Hail Columbia]

http://www.africancrisis.co.za/Article.php?ID=21373&

PRETORIA, South Africa. Extensively drug-resistant tuberculosis (XDR-TB) 'could become a more serious public health risk than AIDS because of the Mbeki-government's inaction.' In fact this inaction by the regime 'will spawn a full-blown XDR-TB epidemic," these top TB-experts are warning.

The researchers, Jerome Amir Singh, Ross Upshur and Nesri Padayatchi, warn that the SA government's initial lethargic reaction to the crisis - which dates from 2002 -- and the confusion and uncertainty among health professionals on how to tackle the XDR-TB outbreaks, 'highlight the urgent need to address these issues.

The team of SA health researchers assessed the risk of the fatal disease which now is spreading rapidly in the mainstream SA population. They conclude that the Mbeki regime's health authorities were not doing nearly enough to combat XDR-TB.

Even before the onset of XDR-TB, South Africa already had the world's highest TB-rates, with 718 people per 100,000 infected with it. The country has 48 specialist-TB hospitals countrywide, all dating back from the apartheid-era which ended in 1994.

Tuberculosis is one of mankind's oldest-known diseases, even Egyptian mummies were found with it. The bacillus is spread easily from people to people by aerosols created by infected patients' coughing or sneezing.

There are treatment-cures and vaccines for 'ordinary TB', but none for XDR-TB.
http://en.wikipedia.org/wiki/Tuberculosis

"Inaction (will) spawn a full-blown XDR-TB epidemic," warned Jerome Amir Singh, Ross Upshur and Nesri Padayatchi in their paper, titled XDR-TB in South Africa: No time for denial or complacency.
The research is published in the January issue of PLoS Medicine.

XDR-TB is the deadlier strain of multi-drug-resistant TB -- it is highly infectious to others and extremely difficult and expensive to treat.
It has a high and rapid death rate in South Africa - some 99% of the XDR-TB patients die within ten days of diagnosis.

The researchers' warnings were underlined by recent problems in the Eastern Cape when dozens of patients with XDR-TB and MDR-TB broke out of two hospitals where they had been living in enforced isolation for months so they could go home for Christmas.
Authorities spent weeks searching for them. Some indeed are still missing.

XDR-TB was first identified in South Africa in 2002 in George in the Western Cape, and it broke out of its hospital confines in 2006 in rural KwaZulu-Natal.
It now is identified in all of the country's provinces; MDR-TB had already emerged before that time.

In January 2006 the SA Medical Research Council estimated that there were 6,000 cases a year.
The researchers warned that XDR-TB was now considered endemic to KwaZulu-Natal with at least 30 new cases officially reported there each month and 300 cases nationally.
"Diagnosed cases of XDR-TB likely represent a small proportion of the extent of the problem," they also warned.
In November the health department confirmed 481 cases of XDR-TB and 216 of those patients had died. Since that time, no new death-statistics for XDR-TB have been issued by the SA health department.

"XDR-TB is a serious global health threat," the SA researchers warned. "It has the potential to derail the global efforts to contain HIV/Aids, as broadly disseminated XDR-TB will prove to be a much more serious public health threat owing to its mode of transmission."
The researchers said the emergence of MDR- and XDR-TB was an indication of the poor implementation of the TB control programme.

EPIDEMIC DUE TO LACK OF INFECTION CONTROL IN HOSPITALS:
This was fuelled by lack of infection control in hospitals and clinics.
They said South Africa should reduce overcrowding in hospitals, expand disease surveillance "and rethink its counselling, treatment and tracing strategies".

The government's social policy was making it difficult for people to get grants while being treated in a public hospital -- so grant policies should be reviewed, they said. TB thrives in the crowded social conditions of the poor, who are often dependent on social grants. They also get free hospital treatment.

"Current government policy stipulates that those who are hospitalised at state expense lose their social welfare benefits for the duration of their hospitalisation,' the researchers pointed out.

"Faced with the prospect of being deprived of their gainful employment and/or having their welfare benefits suspended for the duration of hospitalisation - which in the case of MDR-TB or XDR-TB could last 18 to 24 months - many opt not to stay in hospitals."

SA XDR-TB PATIENTS MIX WITH NON-INFECTED PEOPLE, USE PUBLIC TRANSPORT....

Instead they mix with non-infected people, use public transport and continue working, posing a significant health risk to others.

[Tina Greco - Melbourne]

Rights dilemma for SA

    January 27 2008 at 08:49AM

A guard in a surgical mask patrols a wire fence designed to keep dozens of patients with a lethal form of tuberculosis at Cape Town's Brooklyn Chest hospital isolated from the rest of the world.

Inside the ward, sufferers of extreme drug resistant tuberculosis (XDR-TB), a near untreatable strain of the disease, battle boredom, depression and the side-effects of a daily palmful of pills.

None know how long they have to live.

As doctors and government officials scratch their heads over the inherent clash between individual freedom and the public health risk posed by XDR-TB, patients are more concerned about when, if ever, they can return home.

[crazyhorse]

Rights dilemma for SA

    January 27 2008 at 08:49AM

A guard in a surgical mask patrols a wire fence designed to keep dozens of patients with a lethal form of tuberculosis at Cape Town's Brooklyn Chest hospital isolated from the rest of the world.

Inside the ward, sufferers of extreme drug resistant tuberculosis (XDR-TB), a near untreatable strain of the disease, battle boredom, depression and the side-effects of a daily palmful of pills.

None know how long they have to live.

As doctors and government officials scratch their heads over the inherent clash between individual freedom and the public health risk posed by XDR-TB, patients are more concerned about when, if ever, they can return home.

Not only are the South African public at risk. What about those in the early stages of XDR-TB that are allowed freely to enter other countries on vacation and to work, they are spreading the disease like wildfire. No African should be allowed abroad untill they can prove they are H.I.V. and T.B. free

[Tina Greco - Melbourne]

They need to close them off I totally agree. The travelling public are the worse spreaders of infections. TB is rare in most parts of the world, but allowing such free travel is putting the world at risk.

And people not following correct medical advice are just as guilty. And should be charge with public endangerment and locked up.

[Ambiorix]

This is horrible.
What was the ethnic background of those Christmas-escapers?