Instead of waiting for patients to arrive at clinics, when they are already at risk of dying, authorities should beef up their efforts to find tuberculosis (TB) cases, an expert has recommended.
Professor of pulmonology Keertan Dheda, from the University of Cape Town (UCT), said: “The number of overall TB cases globally has increased, but the number of diagnosed cases has decreased substantially, which is very concerning.”
He said so-called “missing or undiagnosed” patients were a major concern in South Africa, where 100 000 to 150 000 people were diagnosed with TB annually. Many of these patients presented to healthcare centres when their diseases were already advanced and most had severe lung damage, leading to death, he added.
“This calls for improved access to community-based diagnostic tools, and changing our public health paradigm from one of passive case-finding, where patients self-report to the health service, to one of active case-finding, where tools and people (go) into the community to find and treat TB patients.”
TimesLIVE reports that Dheda was responding to the World Health Organisation’s (WHO) 2022 Global TB Report, showing 10.6m people contracted the disease last year, an increase of 4.5% from 2020. The report also shows that 1.6m people died from TB, while drug-resistant cases increased by 3% between 2020 and 2021. In 2021, 45 000 new cases of such TB were diagnosed.
Some 304 000 people in South Africa got TB, with 56 000 dying, with more than half of those who died also having HIV. The report blamed the COVID-19 pandemic and ongoing conflicts in Eastern Europe, Africa and the Middle East for the global disruption of TB services.
South Africa is among the top 10 countries experiencing a decline in notifications of newly diagnosed TB cases in 2020-2021, compared with 2019.
Meanwhile, the TB Advocacy and Accountability Consortium (TBAAC), an initiative of the Rural Health Advocacy Project, will hold a workshop this week to review the impact of the budget on the implementation of the TB Recovery Plan. This aims to find people with undiagnosed TB, link them to treatment and strengthen retention in care and prevention.
Russell Rensburg, director of the Rural Health Advocacy Project, said while October’s medium-term budget policy statement had not delivered a convincing path out of the economic crisis and “it is hard to measure if TB receives sufficient programme allocation to meet its programme priorities”. The workshop planned to work with civil society partners “to understand how we can work together to improve TB outcomes”.
“There are concerns about the decrease of TB case notifications and subsequent increase in deaths, especially considering the disease is treatable and preventable,” Rensburg said.
See more from MedicalBrief archives:
When three epidemics collide: TB, HIV and COVID-19 in South Africa
Digital X-rays increase TB detection in asymptomatic South Africans
SA to expedite TB diagnosis/treatment as cases continue to soar