HERALD Live posted an article by Tshepiso Mametela on 30 April 2024 entitled “Big strides made in fight against tuberculosis.” Read the article from the paper below
MAKING PROGRESS: The Eastern Cape department of health held a TB symposium at the Southern Sun Marine Hotel on Monday. Prof Norbert Ndjeka led the programme SA’s health ministry and biomedical community have set a realistic target to end the scourge of tuberculosis (TB) in the years to come. This is thanks to notable advancements in treatment, resulting in the first cured patient with multidrug-resistant tuberculosis (MDR-TB) in the world in March.
A provincial TB symposium in Summerstrand, hosted on Monday by the Eastern Cape health department under the tagline “Addressing Bedaquiline Resistance”, unpacked the existing challenges and strides in stamping out the infectious disease. It follows the National TB Control and Management Programme’s rollout of a bedaquiline, pretomanid, linezolid and levofloxacin (BPaL-L) regimen at the Jose Pearson TB Hospital in Bethelsdorp in September. Health experts touted it as a cutting-edge therapy, confining the treatment duration to six months, significantly reducing the previous MDR-TB regimen of nine to 18 months. The regimen was able to cure about 90% of MDR and extensively drug-resistant (XDR) TB patients in clinical trials. Despite this, many patients developed severe adverse effects associated with the long-term administration of linezolid.
SA is among the top 30 countries with the highest burdens of TB, DR-TB and TB/HIV co-infection.
At the symposium, the national health department TB control and management chief director, Prof Norbert Ndjeka, said strides had been made to eradicate TB amid ongoing challenges. “It is a major challenge that we need to address,” Ndjeka said. “However, we’ve started to see the fruits of our work since launching the new MDR-TB regimen on September 1. “Patients previously on treatment for nine, 12 or 18 months are now treated in six months.” Ndjeka noted the HIV/AIDS epidemic and its relationship to TB. About half of the people with TB live with HIV. “This means you need to treat both diseases,” he said. “Our fight against TB is based on the National Strategic Plan [for HIV, TB and STIS Goals 2023-2028] of the SA National AIDS Council. “We aim to find at least 95% of people living with HIV, to have 95% on antiretroviral therapy and for 95% to be virally suppressed. “As a country, we’ve only met the first 95%. We must still work hard to achieve the others. “In terms of TB, we must find 90% of those living with TB every year after reaching only 70% last year. “We must treat at least 90% of those, though we prefer to treat them all and cure another 90%. “So, there is still work to be done.” Globally, the net reduction in the TB incidence rate from 2015-2022 was 8.7%, some ways off from the World Health Organisation (WHO) End TB Strategy aim of 50% by 2025. In SA, Ndjeka said the number of new patients annually has dropped by 53% from 2015-2022. “We’re moving in the right direction in TB control. “We expect a decrease but are still experiencing 54,000 deaths yearly. “But, overall, I’m optimistic we’re on the right path for both, though there’s still lots to do.”
Yakub Kadernani, a senior research programme coordinator at Johns Hopkins University for the “BringBPaL2Me” trial in the Eastern Cape and KwaZulu-Natal, said the initiative strove to bring the treatment closer to patients. “Historically, they’ve had to make [long] trips to healthcare facilities such as Jose Pearson TB Hospital or King Dinuzulu Hospital in eThekwini. “We’re striving to decentralise health care, with some clinics allocated clinical health practitioners, who’ve been trained intensively to manage drug-resistant TB at a primary care level. “Through the trial, we hope to shape policy in line with the national health department’s plan to decentralise care completely.”
Sinalo Tunywashe, 21, the first MDR-TB-cured patient, having completed the treatment in March, was one of several survivors supporting the event. He began to present telltale signs of the disease in August before undergoing failed antibiotic treatment and finally enrolling in the clinical trial a few weeks later. “Fortunately, the nurses prepared me adequately for the side effects of taking the [BPaL-L] treatment by sensitising me. “The information helped and informed how I went about incorporating a substantial diet, which helped to manage the side effects better.”