Since the beginning of March, City Health has hosted numerous events, including TB awareness campaigns at clinics , schools, and door-to-door in informal settlements.
On the 24th of March 2023, the Mayoral Committee member for Community Services and Health, Councillor Patricia van der Ross attended a World TB Day event at Tambo Village in the Klipfontein sub district.
City Health has made strides in recent years in terms of the number of persons screened for TB, going from just over 1,7 million screenings in 2021, to more than 1,9 million in 2022. Just under a third of all screening was in children under five years of age, who are particularly vulnerable to TB. More than 90% of people who screened positive for TB and also tested positive on subsequent TB testing, was started on TB treatment.
‘TB remains one of our most critical health challenges, but the good news is that it can be treated, and cured. I am very encouraged by the increase in screening, particularly as these efforts were derailed by the Covid-19 pandemic, but I want to remind the public that it is a shared responsibility. Our staff can only do so much – we also need our residents to be proactive and report to their nearest clinic for screening, particularly if they had contact with someone with TB, or if they show symptoms of infection. It is also possible to have TB and be asymptomatic (not have symptoms), and there are plans to implement new National Department of Health (NDoH) guidelines to have a sputum test even if you don’t have symptoms, if you are HIV positive, had TB previously or have been in contact with someone with TB,’ said Councillor Van der Ross.
South Africa’s National TB programme was among the biggest casualties during the Covid-19 pandemic. TB testing and diagnosis declined by over 20%, and for the first time in over a decade there was an increase in the number of TB deaths (TB National Consortium. 2022).
To respond to this challenge, a TB Recovery Plan has been set out by the NDoH and the TB Think Tank, a collective of experts, academics, researchers and civil society advocates who guide the country’s TB response. The recovery plan brings together several critical strategies that should form part of the TB response over the next year. These will be staggered based on the TB priorities in individual provinces.
CITY OF CAPE TOWN SERVICES OFFERED: NEW AND EXISTING
The City of Cape Town is combining existing and new interventions in the light of the TB Recovery Plan: These include:
· A new TB screening and testing Standard Operating Procedure, allowing for focus on a broader definition of close and household contacts.
· New TB Prevention Treatment(TPT) guidelines released by the NDoH ,expanding the criteria for vulnerable individuals to be protected against TB infection. There are currently two TPT regimens available at the City of Cape Town clinics, with a third to be rolled out shortly. The additional TPT regimens are shorter regimens that has been shown to increase adherence to TPT and improve outcomes .
· Targeted Universal Testing for TB that allows for testing of asymptomatic as well as symptomatic individuals. By testing people at high risk for TB even if they don’t have symptoms we will hopefully find more persons with TB.
· The use of a new diagnostic, TB Urine-LAM to reduce morbidity and mortality in HIV positive patients through early diagnosis of TB.
· Operational research involving a new drug as part of a drug resistant TB regimen of six months, instead of the standard “short course” regimen of nine to 11 months.
· It is also envisioned to, in future, use digital chest x-rays as a screening tool in asymptomatic clients.
STAKEHOLDER INVOLVEMENT/SUPPORT
City Health has been collaborating with different sectors to address the impact of TB, and to find new ways of combating the disease. This includes non-profit organisations and research institutions. Additionally, the Scaling the Use of Data Project, funded by the Bill and Melinda Gates Foundation, aims to implement innovative approaches and more effective data utilisation to improve the outcomes for TB and HIV. A TB treatment action list has been piloted to increase treatment success. This includes flagging patients who have been diagnosed with TB and not yet linked to care at any clinic. These patients are followed up by the healthcare workers and immediately linked to care.
