SA state lab testing for TB has halved since lockdown

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Testing for tuberculosis (TB) at South Africa’s state laboratory has halved since the start of the lockdown, jeopardising the country’s efforts to control the disease and putting additional lives at risk. Business Day reports that the precipitous decline in TB test volumes at the National Health Laboratory Service (NHLS) is the first hard evidence of disruption to health services caused by COVID-19, which was first detected in South Africa on 5 March. Less than a fortnight later the government imposed stringent travel restrictions, banned mass gatherings and ordered the closure of schools, swiftly followed by a national lockdown on 27 March that halted most public transport, confined all but essential workers to their homes and brought the economy to a virtual standstill.

Nazir Ismail, head of the Centre for TB at the National Institute for Communicable Diseases, said a continued lockdown would unwind the gains South Africa had made through its investments in combating the disease and lead to a resurgence in TB cases. “The burden of TB has been declining by 5% per annum over the past few years and compared to eight years ago the number of lab-confirmed TB cases has almost halved,” he said.

Ismail attributed the drop in TB testing at the NHLS, which does 95% of SA’s TB tests, to the reduction in public transport to clinics, patients delaying seeking care, and neglect of TB screening during the lockdown. The laboratory’s TB testing capacity had been unaffected by its well-publicised COVID-19 test backlog, he said.

“TB disease is a spectrum and those with mild but infectious TB will likely delay care until they need more advanced care, which would worsen outcomes and also consume hospital bed capacity,” Ismail is quoted in the report as saying.

Full Business Day report

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