Issued by Department of Health
1 August 2006
Minister of Health, Dr Manto Tshabalala-Msimang is to lead a major national blitz into four districts with the highest cases of tuberculosis and low cure rates as part of the Department of Health’s efforts to address the major problem of TB in the country.
The Department has identified Nelson Mandela Metro and Amatole District in Eastern Cape, Ethekwini Metro in KwaZulu-Natal and Johannesburg Metro in Gauteng as districts posing the highest challenge of TB in the country.
Minister Tshabalala-Msimang accompanied by all Health MECs will be leading campaigns in Eastern Cape, Gauteng and KZN (3rd, 4th and 6th of August respectively), galvanising support for TB control interventions at provincial and local level.
On Friday, August 04, the Minister will meet the South African Business Coalition on HIV and AIDS (SABCOHA) in Johannesburg to mobilise business support and later participate in a community-based TB awareness campaign in Soweto.
Tuberculosis is a major problem in the country with more than 270 000 people suffering from the disease in 2004 and at least 12% of TB patients defaulted from treatment.
The most affected provinces are Eastern Cape, KwaZulu-Natal, Gauteng and Western Cape which contribute about 80% of the total TB burden in the country. In addition to bigger population that makes up these provinces, major factors affecting incidents of TB are:
In August last year, African Ministers of Health resolved at a WHO meeting in Maputo to declare TB an emergency in Africa and agreed to commit more human and financial resources to support TB control programmes.
Arising from this resolution, SA Department of Health developed the National TB Crisis Management plan with a budget of R36,8 million to improve detection and cure rates and reduce treatment default rate in the country.
The Plan seeks to improve systems necessary to support the TB control programme. This includes better coordination of interventions at national, provincial and local levels, improving laboratory services to reduce turn around time for specimens and increasing efficiency of data collection and tracking of patients.
The other component of the Plan is social mobilisation and communication campaign in the four focus areas and nationally. The challenge with TB is to improve awareness about the symptoms, encourage testing and assisting the patients to complete their treatment for the period of six months.
Failure to complete TB treatment poses major challenges including development of multi drug resistant TB. Government spends at least R400 per patient for treating ordinary TB. For multi-drug resistant TB, the cost of treatment dramatically increases to R24 000 per patient (including hospitalization and more expensive drugs).
There are many factors contributing to patient’s failure to complete treatment. A general lack of treatment compliance culture, high levels of poverty and food insecurity and lack of support within families and communities are some of them.
The social mobilisation component of the TB plan addresses these factors through an intensive communication programme which includes community awareness campaigns in focus areas, staff training and mobilisation of Directly Observed Treatment (DOT) supporters that are assigned to specific patients to encourage them to complete treatment.
TB is curable even in the presence of HIV and AIDS. Success or failure is determined by patient’s ability to complete treatment.
Table 2: The following table shows the number of TB patients reported in the identified districts, latest smear conversion rates and treatment outcomes
| Province | District | District Size Km2 |
Population District Barometer 2004 |
No of new TB patients reported in 2004 | Latest Smear Conversion rates 2004 |
Cure rates 2004 |
Default rates 2004 |
| Eastern Cape | Nelson Mandela Metro | 1 952 | 1,028,016 | 8115 | 60% | 42% | 16% |
| Amatole | 23 675 | 1,657,901 | 7906 | 53% | 31% | 11% | |
| Kwazulu Natal | EThekwini | 2292 | 3,240,517 | 24198 | 49% | 32% | 23% |
| Gauteng | City of Johannesburg | 1644 | 3,578,392 | 15323 | 72% | 61% | 11% |
Contact: Sibani Mngadi @ 0827720161