It is 8am on a Wednesday and the final rush of people going to work and taking children to school is dying down. Hezekiel Nyoni (38) greets the Somali shopkeeper as he strolls past the tuck shop near his Tekwane South house, an RDP settlement outside Mbombela in Mpumalanga.
He has an appointment at the Barberton TB Specialised Hospital and is making his way to the spot where the transport organised by the health department will pick him up. But he is not certain whether that will happen.
"The transport is unreliable; sometimes it does not come at all," he says.
South Africa will increasingly move towards nurse-initiated treatment for multidrug-resistant tuberculosis (MDR-TB) in the next five years, and a programme in KwaZulu-Natal Province, which has a high HIV/TB burden, is already training nurses to manage MDR-TB patients.
Faced with a chronic shortage of doctors, South Africa moved to nurse-initiated antiretroviral treatment (NiMart) in April 2010. Now, government plans to roll out nurse-initiated MDR-TB treatment, and to make it and NiMart available at all primary healthcare, antenatal, TB and mobile outreach clinics by 2016, according to the National Strategic Plan on HIV, STIs [sexually transmitted infections] and TB.
South Africa’s move to decentralize the treatment of drug-resistant tuberculosis (TB) has given rise to a crop of nurses equipped not only to initiate patients on HIV treatment, but also to prescribe for and monitor drug-resistant TB (DR-TB) patients. However, experts and government officials say the need for specialist physicians and hospitals will continue, based on research presented at the South African TB conference in the port city of Durban.
JOHANNESBURG, 16 August 2011 (PlusNews) - While countries are rolling out new tests that will enable them to diagnose more patients with drug-resistant tuberculosis (DR-TB), a worldwide shortage of the drugs to treat these patients is likely, Médecins Sans Frontières (MSF) warns.
DR-TB can occur when TB patients do not complete their initial course of TB treatment. The only way to test for DR-TB is through cultures or via molecular testing – neither of which has been widely available in many high incident countries – until the advent of the GeneXpert, a two-hour molecular TB test released in 2010.