The high default rate of patients on the Tuberculosis (TB) treatment programmes is a matter of great concern, City of Johannesburg mayoral committee member for health and social development Mpho Phalatse said on Saturday.
Phalatse’s concerns come as the world commemorates World TB Day on Saturday, which aims to raise public awareness about the devastating health, social and economic consequences of the disease.
Despite significant progress over the past decades, TB continued to be the top infectious agent worldwide, claiming over 4500 lives a day, Phalatse said.
The emergence of multi-drug resistant TB (MDR-TB) posed a major health security threat and could risk gains made in the fight against TB. Many patients with TB were co-infected with HIV.
“TB leads to HIV disease progression and vice versa. In South Africa, 60-70 percent of TB patients are HIV co-infected. The risk of developing TB in HIV patients is said to be 10 percent annually as compared to 10 percent lifetime risk in HIV negative individuals. HIV masks the clinical presentation of TB, leading to delayed diagnosis, continuous transmission of TB, and increased morbidity. There is also an increased risk of disseminated TB in HIV positive patients,” she said.
Of the 14,648 TB cases tracked by the city’s health department in 2016, 12,797 were initiated on treatment. Of the 12,797, 9669 completed treatment, 852 defaulted from treatment, 3128 were cured, and 740 died.
“I am concerned about the high default rate in some areas in the city. Though our community health workers are available to track defaulters and provide treatment support, their efforts are often hampered by the provision of wrong addresses when patients open files at the clinic. We believe this is because of a fear of being turned away if they (patients) do not reside within the clinic’s geographic catchment area,” Phalatse said.
However, the department had made it clear that patients were welcome to attend any clinic of their choice and that they should report any incidents of staff refusing to assist them.
“We will continue to spread this message, hoping to afford our patients a bit more flexibility so we can deal with each other in a more transparent manner. With your assistance we will be able to assist you. Let us work together to finally end TB in the City of Joburg,” she said.
The theme for World TB Day this year was “Wanted: Leaders for a TB-free world”, which focused on building commitment to ending TB, not only at the political level with heads of state and ministers of health, but at all levels, from mayors, governors, parliamentarians, and community leaders, to people affected by TB, civil society advocates, health workers, doctors or nurses, NGOs, and other partners. All could be leaders in efforts to end TB in their own work or terrain.
In keeping with the theme, the city’s health department was hosting TB dialogues across the seven regions, targeted at community leaders such as school principals, NGOs, church leaders, traditional healers, clinic committee chairpersons and clinic representatives, crèche managers, community elders, and hostel Induna’s. The dialogues were aimed at empowering community leaders and building commitment to ending TB, Phalatse said.
