TB and drug resistant TB in South Africa
South Africa is currently burdened with one of the world’s worst Tuberculosis (TB) epidemics, despite its relative wealth, strong health care system, and commitment to combating the disease. Within a population of 50 million, approximately 400,000 new cases are reported each year (World Health Organization (WHO), 2011).
TB is not a virus, but rather a bacterium that reproduces slowly in the body. It is an air-borne disease and is most often spread when an infected person coughs and the bacterium is inhaled by another. Most people who are exposed to TB are able to fight off the infection, although TB can survive in the body for many years after the initial infection has been brought under control by the body’s immune system. In some cases, the latent TB becomes active again, an occurrence that is more common in individuals with compromised immune systems. When active, TB is extremely contagious. TB induces frequent coughing in an infected individual, whose sputum will contain active TB. TB treatment is available and relatively inexpensive; however combating the disease is still a major problem for South Africa and much of the rest of Sub-Saharan Africa.
South Africa has made considerable efforts to combat its TB epidemic, as evidenced by the attention devoted to TB in the National Strategic Plans (NSP) on HIV/AIDS, sexually transmitted infections (STIs) and TB (South African Ministry of Health, 2000, 2007). In fact, the NSP currently being developed has been criticized for devoting too much attention to TB at the expense of HIV/AIDS and other STIs.
Complicating the response to TB, however, is that in addition to the large TB problem, the country is also heavily burdened with Multi Drug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB). In 2010, approximately 1.8 percent of all new TB infections were multi-drug resistant. This number jumps to 6.7 percent for those cases of TB that were being re-treated (World Health Organization, 2011). While there are no official national numbers on XDR-TB available, 511 cases were found to be XDR-TB in 2010 in South Africa, the highest absolute number of infections recorded globally to date.
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