Wednesday, July 29, 2009

A new method of treating tuberculosis in South Africa

A new program started by Medecins Sans Frontieres is helping to make the treatment of tuberculosis easier on it's patients. In South Africa, those sick with TB were effectively quarantined in hospitals to prevent the spread of the virus, but once people realized that they would be locked up for a long time many did not come forward for treatment. The MSF program treats the people in their homes, but they must promise not to leave the homes.

From the New York Times, reporter Celia Dugger explains the new treatment further.

Under South Africa’s current policy, Ms. Vani would normally have been whisked away to a hospital after tuberculosis was diagnosed and isolated from the public for a grueling regimen of toxic, hard-to-tolerate pills and injections, lasting months.

In the neighboring Eastern Cape Province, patients have effectively been imprisoned in a hospital encircled by fences topped with razor wire, and dozens of them have escaped in desperate bids to reunite with their families. Both the Eastern Cape and Western Cape Provinces have sought court orders to compel the return of runaways.

But in this case, Ms. Vani is being treated in a local clinic and lives at home under a pilot program run by Doctors Without Borders and supported by both the city of Cape Town and Western Cape Province. The idea is to show that such patients can be successfully treated in an impoverished community like Khayelitsha even while they are still infectious.

For Ms. Vani to continue in the program, Ms. Beko had to ensure that the young woman could live at home during her treatment with minimal risk of infecting others. Tuberculosis spreads through the air when patients cough and sneeze, and the germs could get trapped in the tiny room where Ms. Vani lives alone.

“They may send you to the hospital, as there are no windows in the house,” Ms. Beko said with a doubtful shake of her head.

Ms. Vani, eager to avoid a long-term hospitalization, promised that she would remain alone in the house and only see friends outside in the open air. “I already told my boyfriend it would not be good for him to sleep over,” she said through a paper mask that covered her mouth.

Drug-resistant tuberculosis is a mounting global health threat. The World Health Organization reported the highest rates of it ever last year. Some 500,000 of the 9 million new cases of tuberculosis in 2007, the most recent estimates, failed to respond to the standard, inexpensive first-line drugs. About 150,000 people died of drug-resistant TB.

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