The provincial Health Department has highlighted a concern of having to shift from hospital-based treatment towards treating patients in communities, as they struggle to get patients to complete their TB treatments.
However, this presented its own challenges, including the change of cellphone numbers, home addresses and some areas not being accessible due to gangsterism.
The ad-hoc committee on TB-related matters at the Legislature was briefed on Wednesday by the Western Cape Department of Health and Wellness on the prevalence of TB across the province before and after Covid-19.
According to the department’s Dr Nousheena Firfirey, every time the country had a new wave of Covid-19 cases, TB testing decreased.
“The longest period of increase in testing occurred between March 2021 to November 2022.
“Though the relative increase in the rate of tests has slowed down in 2023 compared with 2022, it is still above the median monthly rate at 19 301 tests per month,” said Firfirey.
About 74% of people five years and older were tested during 2021, and of those, 17% were confirmed to have contracted TB. Of the 17% about 91% started their treatment, but only 69% finished their treatment.
It was also recorded that 3% of those who failed to continue with their medication had died.
In a dashboard of the metro, which was last updated on June 22, 2023, Dr Nosi Kalawe of the Metro Health Services said 29 100 cases were recorded, of which there were 2 603 TB-related deaths.
“The challenges include that some contacts or patients who have been diagnosed refuse to return to the facility for treatment. Some staff have been threatened during home recalls. There are infrastructure challenges such as space, lack of booths and long queues.
Long waiting lists for social workers also affects TB treatment outcomes, and the shortage of TB staff is an ongoing challenge,” said Kalawe.
Freedom Plus MPL Peter Marais was unimpressed that the Health Department had presented data he called “old”.
“I am a bit disappointed that it’s in 2023 and we were shown statistics that end in 2021, and these were stats provided in a previous meeting. We know what causes TB, it’s poverty and overcrowding.
I don't see serious discussions in the government where they are talking about giving people proper food and nutritions. This is a serious situation and I don’t want to hear percentages but need detailed numbers of cases. We want to know in detail what the previous challenges were and how they were each resolved,” he said.
Health and Wellness MEC Nomafrench Mbombo said a unique patient identifier intervention was helping to find patients.
“The province is leveraging off Covid-19 learnings to strengthen the TB programme. The provincial TB recovery plan seeks to manage TB comprehensively, with various interventions to strengthen the TB response through improved case detection and linkage to care, psychosocial and adherence support as well as TB prevention strategies.”
The department’s chief of operations, Dr Saadiq Kariem, said dashboards similar to the ones used during the Covid-19, which provided detailed demographics over the number of child deaths due to TB, would be supplied to the committee.
“The success rate of 69% implies that around 31% of people did not conclude their treatments. We also have projects where we are following up on people in relation to their treatment and link them to care. Part of our thinking is that if the TB admission case rate goes up it just means it’s bad. It actually shows that detection numbers and case finding are better. We also want to highlight that we don’t have vaccine shortages currently.”
Cape Times