Several Cape Flats health facilities have seen a rise in TB cases along with more patients defaulting on treatment, according to the provincial health department.
Heideveld, Dr Abdurahman, Hanover Park, Inzame Zabantu, Nyanga, and Crossroads clinics; Mitchell’s Plain and Gugulethu day hospitals and Mitchell’s Plain District Hospital saw almost 300 more TB diagnoses last year than the year before.
The 2 775 cases last year were up from 2 481 in 2020, says provincial health department spokeswoman Monique Johnstone.
But the number of TB diagnoses has dropped from 2991 cases in 2019 and 3204 cases in 2018.
The number of patients defaulting on treatment has risen in recent years, says Ms Johnstone. From January 2016 to December 2019, she says, 8 301 patients aged 5 and older were on TB treatment, but that number fell to 7 843, during the Covid-19 pandemic from 2019 to 2021.
However, Ms Johnstone said the department had seen a decline in treatment defaulting for February.
During the pandemic, the provincial health department combined the screening of TB with screening for Covid-19 at health-care facilities.
Most health-care services had been “de-escalated” during the peak of each wave but not TB services, Ms Johnstone said.
Over the next 30 days leading up to World TB Day on Thursday March 24, the department will be tracing defaulters, testing for TB and doing home-based-care visits in communities.
Mayoral committee member for water Dr Zahid Badroodien said TB, and particularly adherence to treatment, continued to be one of the biggest health challenges in South Africa.
Patients with drug-resistant TB had to be on treatment for nine to 20 months, and not sticking to the regimen could lead to prolonged treatment, resistance to medication as well as death and the further spread of the disease, he said.
Anyone with TB symptoms – such as coughing, weight loss and tiredness – should get tested at their nearest clinic, he said, noting that Covid-19 and TB symptoms could overlap.
In September last year, the City’s health department worked with the Aurum Health Institute and the TB HIV Care to test the efficacy of a new treatment-monitoring system for patients with drug-resistant TB.
Some 600 patients are due to be enrolled between September last year and September this year. Each one will get an electronic pillbox that reminds them to take their medication and sends an alert to a computer server whenever the pillbox is opened. The system generates digital adherence reports that can be shared with clinicians.
“This can be used to identify early adherence challenges and provides an opportunity for clinicians to respond appropriately with additional support to clients,” said Dr Badroodien. “Staff are quickly able to identify patients who have missed doses. Improving adherence to treatment will improve outcomes and contribute to reducing disease transmission in our communities.”