Don’t relax, battle far from over

should not sit on our laurels because the battle is far from over.
Tuberculosis is airborne, which makes it easily communicable.
TB is the biggest killer of people living with HIV and Aids in Zimbabwe.
As a nation, we should all be concerned with containing TB since it is airborne.
In the 70s, people used to be quarantined at hospitals like Makumbe Mission in Domboshawa and Drifoentain Mission in Masvingo, but the practice has since been stopped.
It was found out that a person was no longer infectious 72 hours after starting the Directly Observed Treatment Strategy, so putting them in seclusion did not help much.
It was during the time they were not on treatment that they were infectious.
It was a measure taken because then science had not moved and progressed to this stage where they are now fully equipped to tackle the epidemic.
Surely there is nothing much one can do before being diagnosed so there can be no way to curtail the spread because one does not know.
Would one take a measure for something that one is not in the know of? Not possible!
Therefore when one is diagnosed with TB, one is put on treatment as soon as possible.
A nursing sister speaking on condition of anonymity said they did not allow someone to go back home after having been diagnosed with TB without any intervention having been taken.
“We take three sputum tests and if these are conclusive then one does not go back home without having started the DOTS treatment,” she said.
“During all this time one was infectious so we can not allow the cycle to continue without intervention as you know that TB is airborne,” she said.
“TB treatment is free and one can commence medication immediately so there is no reason why one must delay,” she added.
TB treatment is administered in clinics, public hospitals, mission hospitals and a few approved sites that meet the recommendations of the Ministry of Health and Child Welfare.
One would be bound to ask why the treatment is not dispensed by private doctors.
The nursing sister clarified this.
“This is one area where the Ministry cannot afford to relax. They have not allowed private doctors to dispense all in the national interest not as a way to fix them,” she said.
“It would make containing the epidemic very difficult and monitoring of patients would not be possible. There are World Health Organisation guidelines to follow and that has to be done,” she said.
Speaking at a workshop for journalists last year, the district medical director for Sanyati Dr Michael Matimba said the district had recorded only two cases of multi-drug resistant TB.
“We have recorded only two, but we take this seriously because the strain must never be allowed to spread. One was from a woman who had stayed in South Africa and defaulted on her medication. Right now the two are under our care,” said Dr Matimba.
Multi-drug resistance stems from mainly defaulting and every time the person coughs, that strain is passed.
Normally, a person with a non-compromised immunity does not get affected by TB progressing to disease levels.
The system itself is able to fight off the virus and only one in 10 people with full immunity end up getting TB.
This can be due to other causes when their immunity has gone done not necessarily due to HIV.
Patients with HIV are more likely to develop active tuberculosis once infected, and they have a higher risk of dying from TB.
HIV is the most important recognised risk factor for progression from latent to active tuberculosis.
Latent TB is that virus, which is in the body but is unawakened. The compromised immune system gives the virus an awakening thereby causing one to get ill.
But for those with a suppressed immunity because of HIV, the story is different as the virus plays havoc on the person and weight loss, accompanied by night sweating, loss of appetite.
The most common type of TB affects the lungs, which is known as pulmonary TB.
Most TB patients have tested positive to HIV hence the co-infection relationship.
Twin epidemics of HIV and TB are spreading illness and death especially in sub-Saharan Africa and Zimbabwe included.
The region is the worst affected by HIV and Aids epidemic.
In a report by Medecines Sans Frontiers (Doctors without Borders), the co-infection of TB cannot be overlooked.
“Today, an estimated 12 million people are co-infected with these diseases and more than two thirds of them live in sub-Saharan Africa.
“Without treatment, about 90 percent of people with HIV who become infected with TB will die within months of contracting the disease.”
According to the report, in Zimbabwe, official figures show that the incidence of TB has increased exponentially from 97 cases per 100 000 people in 2000 to 742 cases per 100 000 in 2007.
However, less than 40 percent of cases are detected and therefore, treated.
Successful cure rate is 74 percent of those treated.
“In Zimbabwe, one of the biggest health challenges is the consequences of migration in the treatment and follow-up of patients, not to mention the risk of spreading multi-drug resistant TB (MDR-TB) or, in the worst case scenario, extensively drug-resistant TB (XDR-TB) in the Sadc region due to default treatment.
“High proportion of TB/HIV patients are lost to follow-up due to migration to countries like South Africa and Botswana in search for employment opportunities.
“Likewise, there are considerable numbers of patients initiated on anti-TB treatment in South Africa who present to Zimbabwe’s health structures for re-supply of TB drugs posing challenges in forecasting TB drugs consumption statistics for the districts,” said the report.
As stated in the case of the Sanyati woman, she defaulted and by the time she reported at the hospital, she had the strain.
Nationally, 44 cases of MDR TB have been recorded.
“We have recorded at least 44 cases of multi-drug resistant TB and as Government we have moved in quickly to procure drugs enough to treat 90 people,” said Dr Charles Sandy who is the deputy director of TB and Aids programmes in the Ministry of Health and Child Welfare.
Multi-drug resistant TB is when the bacteria in the patient fail to respond to first line drugs, rifampicin and isoniazid which are used to treat the most common cases.
May we as a nation cast off the stigma that we attach to TB.
If you are HIV positive, get tested for TB as well.
The correlation is high and the testing could save your life. Even when HIV positive, TB is still curable although HIV is not.
May you get understanding in all your endeavours!
Till then, God bless you.
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