Weekend Argus (Saturday Edition)
‘Regulations put TB patients at risk’
THE number of tuberculosis (TB) patients who would have started treatment has dropped by 42% since the beginning of the Covid-19 lockdown.
The coronavirus has put a strain on health-care services around the country and the call for people to stay at home since the declaration of a national state of disaster has impacted on disease management.
Earlier this week, the provincial health department briefed the Western Cape legislature’s standing committee on health on what impact Covid-19 has had on TB management across the province.
The department’s Lesley Shand outlined how 3% of patients screened for TB at health-care facilities test positive, with 99% of the sputum samples sent to the lab coming back positive. On average, 89% of people diagnosed with TB start treatment.
However, with lockdown, the province has recorded a number of missed appointments due to physical distancing measures and stay-at-home orders.
A drop in the number of opportunistic screenings has also been observed due to the decrease in the number of people visiting health-care facilities.
From March 3, the number of TB-related visits to health centres dropped from 9000 to just over 2000 by April 9.
And of the 52686 patients diagnosed with TB, 48043 started treatment while, 4 643 were lost to the system and, therefore, not on medication.
Shand said the provision of repeat medication meant that there was also less supervision of patients. Chief director for strategy and health at the department, Krish Vallabhjee said they were distributing communication to patients to not default on their treatment.
Vallabhjee said the focus on defaulters was to ensure that none of them go on to develop the more aggressive drug-resistant TB, which is more difficult to treat.
Vuyani Macotha of the Treatment Action Campaign said: “Since the lockdown, we did a situational analysis and noticed a huge drop in not just this province but across the country in the number of TB patients accessing their medication.”
“For Gauteng alone around 10000 patients decided not to collect their medication and for the Western Cape this figure stands at close to 4 000 patients.
“That is a worrying issue for us. We are of the view that government is focusing all its efforts on Covid-19 and moving away from HIV and TB. There is no big emphasis to encourage patients to take their medication.
“What we have done on our end is collected the names and phone numbers of patients who had stopped taking their medication and worked on encouraging them to continue taking their required medicine.” Macotha said despite the fear in possibly contracting Covid-19, some patients were simply not being issued with sufficient medication to get them through the month.
“Accessing adequate medicine is an issue. For instance, in Paarl, we have had a number of clients who complained that instead of getting treatment for three months, they are given medication to last only 27 or 28 days and only given a return date 30 days later,” he said.
“We have had patients sitting at health-care facilities for hours because of capacity issues with staff and priority being given elsewhere and patients sometimes to come back on a later date without medication.” The department said stable TB patients received their medication at home from community health workers to avoid going into facilities or through a pick-up point at some facilities.
It was only those at risk of acute decompensation who would continue to be seen at primary health-care facilities.