World TB Day is an international opportunity to draw the world's attention to the growing TB epidemic. The World Health Organisation slogan for this year is 'TB anywhere is TB everywhere' which emphasises that every country has to be alert and be part of the worldwide fight against TB due to the ease with which TB is spread. One untreated TB patient can infect another 10 people in one year if left untreated!
The City will be honouring clinic staff and related NGOs in a World TB Day celebration at the Oliver Tambo Hall in Khayelitsha at 13:00 on Friday, 23 March 2007. Media representatives are invited to attend this programme.
Internationally TB is once more seen as a health emergency due to the growing extreme drug resistant TB (XDR TB) outbreak in South Africa and elsewhere in the world. This deadly outbreak has seen eight such cases confirmed in Cape Town of which one has died.
It is great to be able to bring some good news into this scary situation which suggests a serious breakdown in the National TB Control Programme in South Africa. The City of Cape Town's City Health Directorate has reached it best quarter TB cure rate for new smear positive TB (i.e. those cases which are infectious and spreading TB) ever at 76% cured, and 83% successful completion of treatment (probably cured but not proven by two negative sputa checks).
Epidemiological modelling suggests that if 85% of new smear positive TB cases can be cured, then the epidemic will begin to decline as the infectious pool in the community shrinks.
Cape Town as a health district had the second highest caseload of TB in South Africa in 2006 (Durban had more cases). The City had 26,641 cases (26,860 in 2005). To reach a 76% cure rate and 83% successful completion of treatment with these numbers is due to the dedication, hard work, commitment and passion of City Health's clinic staff, managers and of course superbly supported by TB NGOs - particularly TB Care Association.
These results showed huge gains in cure rates in many of the eight health sub districts in the City. Khayelitsha which has 21% of the caseload showed an 8% improvement in cure rate from the previous quarter. Mitchells Plain showed a 9% improvement to a cure rate for the sub district of 85%! Klipfontein sub district (Athlone area, Guguletu and Nyanga) also did extremely well with a 6% improvement on the previous quarter to reach a cure rate of 82%. These results meant that the overall cure rate for the City jumped by 5% as these three sub districts are the high burden areas of the city.
These good TB results are built on the back on the successful HIV prevention and treatment programme run by the Provincial Health Department and City Health. This programme has seen 19,230 clients in the City put on anti retroviral treatment. This is important as an untreated HIV positive person has a 10% yearly chance of contracting TB. This compares with an HIV negative person only having a 10% lifetime risk of contracting TB. In effect this means an untreated HIV positive person has a 60 times greater chance of contracting TB! Almost all extreme drug resistant cases are HIV positive. In Cape Town one out of every two TB patients is HIV positive.
Multi drug resistant TB cases in the city have remained fairly constant at 1% of new cases and 4% of re-treatment cases. This is thanks to the good TB control programme and with the latest excellent results we hope to start to see a decrease in these MDR cases.
Overall these excellent results are due to the following factors:
- The dedication, hard work and passion of staff and TB Civil Society Organisations
- Improved systems implemented and supported by local manager
- Strong monitoring and evaluation of the programme with feedback to all concerned
- Partnerships between City Health, Provincial Health Department and TB NGOs
- Additional funding of R5 million by the Provincial Health Department to high burden sub districts
- Affirming staff and TB NGOs through awards and certificates
Communication and Marketing City of Cape Town
Tel: 021 400 2201
Fax: 021 957 0023
Dr Ivan Toms
Executive Director: City Health
Tel: 021 400 2100
Mobile: 084 220 0143