THE Western Cape government is planning to declare tuberculosis a public health emergency ahead of commemoration of World TB Day as treatment success rates in the province were impacted by Covid-19 and decreased.
During a briefing to the standing committee on health by the South African TB caucus, plans to form a provincial caucus for the Western Cape were highlighted this week.
In his State of the Province Address last month, Western Cape premier Alan Winde pledged to create a plan to fight TB, saying he was concerned by the growing test positivity rate for TB, which indicated that there was not enough testing done to pick up new cases.
Winde said positivity rates increased from 13% in March to 18% in May and peaked at 21% in September that same year. He added that 89% of people confirmed to have TB in the Western Cape were on medication which resulted in successful treatment outcomes of 77%.
However, according to data released by the Western Cape Health Department’s Dr James Kruger during the health committee’s sitting this week, a 77% success rate was the lowest rate in the past five years, which stood at 83% back in 2017.
* As many as 10% of TB patients did not continue follow-ups, either because they did not start treatment or it was interrupted for two or more consecutive months.
* A 35% drop in the number of patients who visited health facilities was noted in April 2020 compared to the previous year.
* There was an overall decline in the number of people who tested for TB from April to December last year While figures increased between September and December, they once again dipped in December.
* A 53% decline in people diagnosed with TB was also recorded in April when compared to the previous year. By December, 1 456 people were diagnosed, which was less than half the previous December figure of 3 627.
The National Tuberculosis Prevalence Survey released last month revealed that 390 000 people lived with the disease in 2018 and more 150 000 of them missed screening, diagnosis and or treatment.
“We are struggling with our TB success rate and that is on the sum of patients being cured and those on treatment. If you are talking about the TB caucus and political leadership, it would be around how do we mobilise communities so that when they are diagnosed, how do they stay on TB treatment once identified and how to prevent TB?” said Kruger.
“There was a recommended five-year plan and some of the key things is the need to strengthen the focus on TB in children and adolescents, timeous initiation of treatment (because we take too long to put people on treatment and we lose them) and completion of TB treatment. And the most important thing being the capacitation of staff – as you can appreciate, in the health service people move in and out.”
Kruger said plans were under way for key developments and announcements either before or on March 24, for the commemoration of World TB Day.
“The whole idea is that we are hoping to move to World TB Day. We got a mandate and the decision was made that we should move forward. We have met with our MEC (for health) and we are proposing that the TB caucus should be launched either on March, 24 or before that.
“The premier made it clear he wants to declare TB a public emergency in the Western Cape. The theme for this year is ‘Time to end TB’, but we thought we wanted to use the provincial theme which is 'The clock is ticking’.”
Winde,in his State of the Province address, said while the second wave of Covid-19 infections had an impact on plans to return health-care services to the people, it was important work towards a strategy.
“That is why in the year ahead, our Department of Health will be pursuing every single person who might have TB and ensuring that they get tested and put on treatment – as a matter of priority. We will also ensure that our HIV testing and treatment increases to pre-Covid-19 levels,” he said.
Chairperson of the committee, Wendy Philander, said: “While the Western Cape holds the highest number of TB patients in the country, the province offers the most effective treatment, evident in the fact that it has the lowest TB mortality rate.
“I will ask parliamentary questions regarding the number of ’missing’ TB patients in the Western Cape during the management of Covid-19, as well as how the proposed TB caucus would supplement the work of the Western Cape Government’s 90-90-90 TB-Strategy.”