URGENT action, including rapid diagnosis, better access to medication, improved home-based care and more community-stay facilities for patients, is crucial in addressing the rising transmission and infection rates of incurable TB.

These were among the findings of a six-year study, involving 69 patients from the Northern Cape, conducted by the South African Medical Research Council (SAMRC). Nearly 300 patients from the Northern and Western Cape were involved in the study, which saw more than half of participants with incurable TB survive for an average of 16 months.

In total, 273 adult patients with microbiologically confirmed extensively drug-resistant tuberculosis (XDR-TB) were recruited from Upington’s Harry Surtie Hospital and the Brooklyn Chest Hospital in the Western Cape, as both facilities are designated specialist referral centres for the treatment of all XDR-TB patients in their respective provinces. All patients were admitted to the designated hospitals during the study period and received a specific treatment regime in accordance with the prevailing national guidelines. They then received follow-up evaluations until the study’s censor date at the end of October 2014 or the time of their death.

At censor date, 186 (68 percent) patients had died while 203 (74 percent) of the participants had unfavourable treatment outcomes (treatment failure, treatment default, relapse, or death while on treatment). Of the 172 (63 percent) patients who were discharged from hospital into the community; 53 (31 percent) had died within 12 months while 89 (52 percent) had died by the end of study.

“More than half of the discharged patients with incurable tuberculosis remained alive for an average of only 16 months,” said University of Cape Town Professor of Medicine, Dr Keertan Dheda.

“These highly infectious patients were associated with the downstream generation of further cases of incurable TB”

According to president and CEO of the SAMRC, Professor Glenda Gray, the rise of incurable TB and TB in general underscores the need to address poverty, overcrowding and the HIV epidemic in Africa, and globally.

“This emphasises the need for appropriate containment strategies that will curb transmission”, she added. Incurable TB refers to an almost totally drug resistant type of TB.

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