adminCatherine Murombedzi H I V Column
IN Zimbabwe cases of MDR tuberculosis reported in the past year showed a rise in the number of infections. Nationally in 2011 there were five cases of MDRTB that were reported. The rise to +120 can be argued that it is not a true reflection of the increase of MDRTB because GeneXpert machine was not widely available, so detection of MDRTB was limited then, but is now possible using the GeneXpert because the machine is now available in 10 provincial hospitals.
Four years, the gadget was only found then at Murambinda Mission Hospital run by Catholic sisters in conjunction with MSF.
This shows that detection in other areas which did not have that machine was not possible, but thanks – today many provincial and district hospitals have GeneXpert in place hence detection of MDRTB is now wide. It could also explain the “rise” in MDRTB cases noted nationally up to year-ending 2014.
The main drugs used in TB treatment in Zimbabwe are rifampicin and isonizaid and when these fail to work patients then develop resistance to treatment.
TB treatment in Zimbabwe is offered free of charge, but surprisingly people still report late and at times with fatality noted.
TB and HIV co-infection is a factor that cannot be ignored in Zimbabwe as 70 percent of TB patients also test HIV positive. MDRTB is then found in mostly people who have had TB treatment before and are also on anti retroviral therapy.
Health personnel in district hospitals seem not prepared and equipped to handle MDRTB patients. A case in point is that at Karoi District Hospital where such patients are housed in a wooden hostel and have to use outside amenities for ablution. The nurses are afraid to handle the patients and neglect was noted by a health monitoring team that visited the hospital in 2013.
Mr Stanley Takaona who headed the team noted with concern the poor and lack of support for MDRTB patients at Karoi Hospital.
“On our visit to Karoi District Hospital we sadly noted three patients who were housed in a wooden house and had to use outside toilets and bathroom. The nursing staff showed fear of contracting the MDRTB hence they did not handle the patients correctly,” said Mr Takaona.
Mr Takaona said MDRT patients were in capable hands in places where MSF operated from.
“We have been to Tsholotsho District and I am pleased to say MSF has built a half way hospital for MDRTB patients. The patients are on full treatment and hence pose no threat of further resistance. They have decent facilities and the health personnel treats patients with care,” said Takaona.
Most hospitals in Zimbabwe refer MDRTB patients to access treatment from home and for some patients the distances they have to travel on foot is 10km and above hence they fail to adhere. Accessing treatment from home poses a further threat as spread to family members is exposed.
MSF is calling for affordable medicines to treat TB by repealing the TRIPS. They are therefore lobbying for more use of generic medicine which has saved millions of lives. Generic medicine has saved lives of millions in the developing world hence Indian pharmacies are dubbed third world pharmacies.
Online Reporter