A Cape Town survivor of extensively drug-resistant tuberculosis has taken her campaign for better access to testing and treatment from her hometown of Khayelitsha to Paris and beyond.
In August, 23-year-old Phumeza Tisile beat the odds and became one of only a few hundred South African who beat extensively drug-resistant tuberculosis (XDR-TB) each year. After an almost three-year battle with XDR-TB, Tisile has helped launch a campaign for better access to drug-resistant TB (DR-TB) testing and treatment.
New research has shown that rapid GeneXpert tuberculosis (TB) test improves access to TB diagnosis and treatment, and may be ready for South African clinics.
Conducted in part by the University of Cape Town (UCT), the study looked at whether it was possible for nurses – instead of laboratory technicians – to administer the test in clinics in four countries, South Africa, Zimbabwe, Zambia and Tanzania.
The Medicines Control Council (MCC) has granted patients with extremely drug-resistant tuberculosis (XDR-TB) access to Johnson & Johnson’s experimental drug bedaquiline, even though it has yet to be registered in South Africa.
The death rate for patients with XDR-TB relying on current treatments is about 80%, according to Helen Cox, an epidemiologist with Médecins Sans Frontières in Cape Town.
The development follows an intense campaign by local activists and doctors, who have argued the drug represents the last hope for patients who do not respond to treatment. South Africa has one of the world’s highest numbers of patients with drug-resistant TB, fuelled by the HIV/AIDS epidemic.
Scientists have found an alarming number of cases of the lung disease tuberculosis in Africa, Asia, Europe and Latin America that are resistant to up to four powerful antibiotic drugs.
In a large international study published in the Lancet medical journal on Thursday, researchers found rates of both multi drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were higher than previously thought and were threatening global efforts to curb the spread of the disease.
Key Issues in the Management of Drug-Resistant Tuberculosis
1. Multidrug-resistant tuberculosis (MDR-TB) is defined as tuberculosis (TB) disease where there is in vitro resistance to both isoniazid and rifampicin, with or without resistance to other anti-TB drugs. As isoniazid and rifampicin are the two most important first-line TB drugs, their removal through resistance from the anti-TB drug armamentarium has serious implications.