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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

    


 

Namibia Losing TB Battle

Christof Maletsky

NAMIBIA is failing to stem the rising tide of tuberculosis (TB) cases in the country.

The World Health Organisation (WHO) released a new TB report on World TB Day yesterday saying Namibia has a 98 per cent detection rate but only half of these cases are being treated successfully.

The revelation of the "substantially below average" success rate follows a warning by the Global Fund to Fight AIDS, TB and Malaria about the "very low" success rate of the TB programme.

The WHO report says only half the cases detected during each of the past six years were successfully treated through the Directly Observed Treatment, Short course or DOTS strategy.

 


WHO has set the target rate for success at 75 per cent.

In 1996 the treatment success rate in Namibia was 54 per cent, in 1997 it was 58 per cent, 60 per cent in 1998, 50 per cent in 1999 and 53 per cent in the year 2000.

The detection rate differed from 75 per cent to 98 per cent over the same period.

The seventh WHO annual report on global TB control says the incidence rate of the disease is growing at approximately 0,4 per cent a year, but much faster in sub-Saharan Africa and in countries of the former Soviet Union.

The report notes that six per cent of the 4 013 cases registered in 2000 ended in deaths while 14 per cent of the patients failed to complete the treatment programme.

In 1998, some 1 456 deaths were attributed to TB.

Between 1995 and 2000, TB cases increased at an average rate of 10 per cent a year.

The WHO says the co-infection of TB and HIV-AIDS, as well as multi-drug resistance to the disease, are major factors leading to the low success rate of the programme.

They also blamed patients who abandon their treatment.

 


The development of multidrug-resistant strains has been on the increase, caused by inconsistent or partial treatment of ordinary TB.

Drug-resistant strains can cost up to N$25 000 to treat, as opposed to N$250 to treat a new infection.

At best, only half of those infected with the new strains can be cured.

The poor TB success rate has also been attributed to the stigma surrounding HIV-AIDS, since the two are linked and many people are ashamed to be identified with either disease.

TB is the second leading cause of death in Namibia and is responsible for 16 per cent of institutional deaths and a significant number of inpatient and outpatient attendance.

Under the DOTS strategy a person diagnosed with TB has to take medication every day for six months.

For those who do not, TB can be deadly.

One person can infect up to 15 others.

DOTS, which has achieved 95 per cent cure rates in countries such as China, Peru and the US, was implemented in Namibia in 1996.

When drug treatment stops, the body builds up resistance to medication, reducing options for further treatment.