On World TB Day, 24 March 2012, theWestern Capeis launching its strategic plan for HIV and AIDS, sexually transmitted infections and tuberculosis (TB) for the period 2012-2016. This is the first time that TB is included in the HIV strategy and marks a milestone in the Department of Health’s response to the dual epidemics of HIV and TB.
Western Cape Health Minister Theuns Botha, who also chairs the province’s AIDS council, says the dual epidemic response acknowledges that TB is posing huge challenges in this province. The plan has expanded its prevention, treatment, care and support interventions to also address the social drivers of ill-health, and moving the strategy into government’s sector plan. This means that the strategy has been developed through wide consultation and that all government departments, the various sectors, business and civil society will participate in implementing the plan.
The key strategic objectives for the next five years include:
Addressing social and structural barriers that increase vulnerability to HIV, sexually transmitted and TB infections
Preventing new HIV, TB and sexually transmitted infections
Sustaining health and wellness
Increasing the protection of human rights and improving access to justice
In the Western Cape HIV/AIDS and Tuberculosis still constitute the largest burden of premature mortality and rank among the three major causes of shorter life spans. The strategic plan will provide direction for all sectors on how to effectively respond to the twin epidemics.
The national theme for this year is “Zero infection, Zero deaths, Zero stigma in my lifetime”. In order to achieve the sentiments of this national slogan, theWestern Capeaims to detect and treat cases early to minimize the spread of infection.
The national incidence of TB is 823/100 000 population and theWestern Capeis slightly higher at 935/100 000. TheEastern Capeis the only province with a per 100 000 incidence higher than theWestern Capeat 960/100 000.
At the same time theWestern Capeleads the country in its significant progress through the TB strategy. New smear cure rates for TB in this province stands at 80.5%, which is the highest TB cure rate achieved inSouth Africa. Patients who successfully complete the full course of treatment is at the World Health Organization target of 85%.
Recent statistics for people who have TB in theWestern Cape(both children and adults)
| TB Cases | 0-4 | 5-14 | 15-24 | 25-34 | 35-44 | 45-54 | 55-64 | 65-74 | >74 | Total | |
| All TB Cases |
M | 2640 | 910 | 3284 | 6484 | 6418 | 3970 | 1597 | 428 | 138 | 25869 |
| F | 2355 | 1002 | 3696 | 5958 | 4269 | 2145 | 883 | 317 | 130 | 20755 | |
| TOTAL | 4995 | 1912 | 6980 | 12442 | 10687 | 6115 | 2480 | 745 | 268 | 46624 | |
TB prevalence in the different districts
| Per 100,000 | |
| CAPEMETRO | 799 |
| CAPEWINELANDS | 1013.4 |
| CENTRAL KAROO | 1013.3 |
| EDEN | 976.7 |
| OVERBERG | 1054.9 |
| WESTCOAST | 1224.9 |
Although TB numbers in theWestern Capehave been decreasing over the past 4 years, this is unfortunately not necessarily an indication that the epidemic is under control or even stabilizing. The high percentage of patients testing highly positive on diagnosis is an indication of undiagnosed, untreated cases in the community.
For this reason the Western Cape Government Health will start a case detection campaign, to be continued for the next 12 months. The situation will be evaluated in 2013 and strategies re-assessed.
Provision of TB medication
All patients are offered education and counselling in preparation for adhering to the course of medication on diagnosis. A regular 6-month TB medication course is costed at R500.
Initially medication is provided at health facilities for a period of two weeks to monitor patients for adverse drug reactions and compliance as well as acute management of any other health problems. Medication can be continued at the health facility on a daily or basis or through a community care worker.
Complicated and TB/HIV co-infected patients have access to 6 TB hospitals in the province.
Accessibility of TB drugs inSouth Africa
TB drugs are procured on a national tender and are available at all health facilities inWestern Cape. The calculation of drugs needed is based on the number of cases treated the previous year plus an inflator (%) based on year-on year increases in numbers. The country produces the required TB drugs locally.
TB drug trials referral sites:
www.new.tballiance.org/newscenter/view-innews.php?id=753
www.allafrica.com/stories/201202101094.html
www.thebodypro.com/content/art59449.html
www.southafrica.info/about/health/tb-091110.htm
