As more and more South Africans are infected with ever more incurable forms of drug resistant tuberculosis, government programmes that once could be counted on to bring TB under control are no longer adequate. So what can be done to keep South Africans safe? Or is the growing epidemic out of control?
Diagnostic tools have failed the medical profession as well as patients. It takes as long as 8 weeks to confirm whether a patient is infected with TB – and another couple of weeks to say if the TB is drug resistant or not.
Just over half of TB patients are cured in South Africa and since 1996 the number of cases has doubled. The cure rates for multiple drug resistant TB is less than 50% and for extensively drug resistant TB, even less than that.
Despite the fact that ordinary TB can still be cured, archaic drugs and established treatment programmes have just not kept up with the intensifying epidemic. With one in six to one in seven people with HIV worldwide living in South Africa , TB has acquired a dramatic new face. People with compromised immune systems are significantly more vulnerable to TB infection. The twin epidemics are running away with us.
In this documentary we track the dramatic rise of extensively drug resistant TB, from the notorious 2005 Tugela Ferry outbreak, right through to the renewed scientific energy that's now being poured into new diagnostic tools and treatment for TB.
Treatment for ordinary TB is an arduous six months of taking a handful of pills daily under supervision. Imagine extending that treatment to 18 months or two years – as happens when a patient developes multi drug resistant TB. Imagine a cocktail of drugs and injections that can have debilitating side-effects ranging from nausea to hearing loss. Imagine being stigmatised by society and cut off from real life when you come forward and get diagnosed with MDR TB. Imagine hearing there is no cure when you hear you have XDR TB... and it becomes clear why treatment programmes that favour isolating MDR and XDR patients in dedicated TB hospitals have done little to inspire cooperation and compliance in the growing population of patients living with TB. It also becomes apparent why it can take an average of 17 months for patients to come forward with suspected TB.
But it’s not all gloom. There have been innovations in treatment – such as treating drug resistant TB patients at home – that are being tested in a country where there are simply too few hospital beds and too many seriously ill people. And in the absence of immediate relief with respect to new drugs and diagnostics, more creative applications for the drugs we DO have available are being sought.
This documentary was filmed by SABC cameraman of the year Byron Taylor, directed by Anna-Maria Lombard and produced by award-winning health news agency Health-e News Service.
TB is curable, TB is preventable and you need to look after yourself!
A documentary by the SABC’s Special Assignment programme about drug resistant TB and TB in the era of HIV has emerged. It gives an in-depth look at this disease and the difficulties associated with it.
Producer Anna-Maria Lombard says the documentary highlights the challenges in the TB control programme: “I was shocked to see the intense burden on patients. Until Tugela ferry the world hasn't really been paying much attention to making it easier for patients and then we take patients away from home for six months and put them in a TB hospital. I mean imagine if you had to do that in your life what that will do to your life and your family?”
Lombard says when she first started at the TV Unit there she realized they had to pay more attention to stories to this and put more pressure on the system and to test it so they can affect change.
Quick diagnosis
She says it is vital that people are diagnosed and put on medication quickly because there have been cases where people where misdiagnosed. “You know in someone who lives with HIV it manifests differently its not always going to be in the lungs, you can get TB of the spine, TB meningitis, and TB looks different so it's harder for doctors to diagnose, so its harder for the system to pick up.” She says these where some of the kind of problems that they come across and highlighted in the documentary. Lombard says the documentary shows that there is an immense commitment that exists within doctors within he healthcare workers to address TB. “Scientists have started to place intense focus on TB. There is immense enthusiasm, passion in some quarters and that I think is cause for hope. Well there’s Bill Gates but is there enough money government just announced massive in increases in funding TB and the TB control programme.”
The documentary will be broadcast on Special Assignment on Tuesday.
Edited by Melissa Naicker and Khensane Maranele
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