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TB: 'Patients are the weakest link'
Natasha Joseph
2008-08-22

Nearly 50 000 people in the Western Cape are receiving treatment at provincial health facilities for tuberculosis. Of these, 450 people are being treated for the multidrug-resistant (MDR) strain and 55 for extensively drug resistant (XDR) TB, says Health MEC Marius Fransman.

But the figure is most likely much higher: the Department of Health says it has no way of knowing how many people in the province have TB but have not yet been diagnosed. According to figures supplied by the provincial department at a South African TB Vaccine Initiative seminar in February, the Western Cape has the second-highest incidence of TB after KwaZulu-Natal - 1 030 among every 100 000 people. South Africa has the seventh-highest incidence of TB globally, with a national TB burden of 722 in 100 000 people. At the same seminar, the department supplied figures for recorded TB cases in the Western Cape that showed these had climbed from 27 509 in 1997 to 48 989 in 2006.

Last year, the city's health department announced that Cape Town's TB cure rate was 76 percent for new smear-positive patients. There was an 82 percent success rate in treatment. For the first quarter of last year, there was a cure rate of 78 percent for new smear-positive cases. Of the 89 percent of the patients tested for HIV, 51 percent were found to have the virus. The Western Cape has by far the highest TB cure rate in the country. In a statement on Thursday, Fransman said it was not possible to evaluate the province's success rate for treating and curing XDR-TB, as the strain had been diagnosed only at the beginning of last year.

Five XDR-TB patients in the province had tested sputum negative since the disease appeared and had been discharged from hospital. Fransman said 55 XDR-TB and 450 MDR-TB patients were being treated as in-patients at provincial health facilities. About 49 000 people with TB were being treated as outpatients at the province's TB facilities, Fransman said. He identified TB patients who failed to take their medication as required as one of the province's biggest challenges in tackling the TB epidemic.

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