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March 29, 2010
Cape Town makes strides in combating tuberculosis

Gladys Jaxa, a TB patient in Khayelitsha township.

March 24 was World Tuberculosis Day, so Worldfocus decided to take a deeper look at the disease that has long been a deadly threat.

Tonight’s Worldfocus special edition on deadly diseases includes a piece by Debra Daugherty about how one South African community has somewhat successfully combated the disease.

Despite advances, tuberculosis nevertheless remains a deadly threat around the globe. The New York Times describes the South African fight against tuberculosis:

South Africa, the richest country in the region, has poured money into building more space in hospitals for drug-resistant TB patients, but researchers say the number of new patients will grow faster than the country can add hospital beds…

It is hard to imagine a more ideal place than [Khayelitsha, a township outside Cape Town] for the spread of tuberculosis, a disease that hovers in the air. People here live at close quarters in overcrowded shacks that sprawl, like colorful jumbles of debris, as far as the eye can see. They go to work crammed into minibuses. They gather in the evening in the homes of friends who have televisions, or in small saloons…

The idea [of the new pilot program] is to show that such patients can be successfully treated in an impoverished community like Khayelitsha even while they are still infectious.

Tuberculosis is fueled in areas with rampant poverty, overcrowding, HIV and substance abuse and many factors. Cape Town suffers a high rate of TB but has managed to “achieve the best cure rate for the disease (almost 80%) compared to other metros in the country last year.” According to the city’s government:

Cape Town has an extremely high number of TB cases with 28,956 reported cases in 2009 and an incidence rate of 877 per 100,000 (compared with a national figure of about 500 per 100,000).

For its progress, Cape Town has been awarded by the United Nations for its efforts in the battle against TB. According to South African newspaper The Good News:

[Cape Town] received the award for its creative response to two different problems affecting poor communities in Cape Town. The first problem is that the incidence of TB has been rising consistently over the last 10 years while cure rates have remained static. This is partly because patients fail to complete the lengthy treatment or their response to treatment is not adequately documented, due to the intense pressure that nursing staff work under.

The second problem, though not directly a health issue, is the question of unemployment, especially for recently matriculated learners who are unable to find a foothold in the formal economy.

In response to these problems, city, provincial and TB/HIV Care Association health officials came up with the idea of employing unemployed school leavers as TB assistants and TB clerks to monitor and record TB treatment schedules.

After receiving the award in February 2010, the city published new targets for combating TB in 2010.

  • New smear positive TB cure rate per quarter: 78%
  • Slow the rate of increase of TB per 100 000 of Cape Town population: ≤1090
  • % TB patients tested for HIV: 90%
  • % HIV-positive TB patients who have a CD4 count: 95%

– Stephanie Savage

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