Zimbabwe figures in TB report shows grim picture

Submitted by godsway about 11 months ago

Zimbabwe figures in TB report shows grim picture

Godsway Shumba

HDN Key Correspondent, Zimbabwe

RIO DE JANEIRO – Zimbabwe is far from achieving the Stop TB Partnership’s targets of halving TB prevalence and mortality rates by 2015 compared with their level in 1990, according to the latest WHO report (Global Tuberculosis Control Report 2009) on global TB control.

The report released on World TB Day during the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil, shows that there were 104,000 incident cases of TB and 95,000 prevalent cases of TB in 2007. Sixty-nine percent (69%) of all new TB cases were also HIV positive.

There were 28,000 deaths from TB among HIV positive people in 2007, and an additional 7000 deaths among HIV negative TB cases.

TB prevalence in 2007 was 714 cases per 100 000 population, short of the 205 cases per 100 000 population target for 2015. The mortality rate during the same period was 265 deaths per 100 000 population, also short of the 70 deaths per 100 000 population target for 2007.

In an interview at the 3rd Stop TB Partners' Forum, the National TB Coordinator, Dr Charles Sandy said the major challenge is that Zimbabwe doesn’t have enough diagnostic facilities and qualified personnel to carry out TB work.

“For example, there is no diagnosis of TB happening in Gokwe North, a district with about 300 000 people,” he said.

Dr Sandy used another example of Harare city council with a population of approximately 2 million people where TB diagnosis is only happening at one facility: Beatrice Infectious Diseases Hospital.

He disclosed that the other hospitals in the city such as Parirenyatwa and Harare Central Hospitals do not have enough resources to perform TB diagnosis and can only attend to a few patients.

“The recommendation is to have one facility for 50 – 100 000 population but here we are talking about a city of 2 million people using only one facility,” Dr Sandy said.

Little is still known about the extent of multi-drug resistant TB (MDR-TB). The new report still relies on the data from a survey carried out in 1995 that indicates a 1.9 per cent prevalence of MDR-TB in all TB cases.

The case detection rate of all new TB cases recorded at Directly Observed short course (DOTS) centres was 37 per cent in 2007. This is 33 per cent short of the World Health Assembly (WHA) target of 70 per cent.

Majority of Zimbabweans live on less than 1 US dollar per day and cannot raise money to cover transport costs needed to travel long distances to access limited diagnostic facilities.

“The case detection rate in 2007 is very low because most of our patients are very poor and cannot raise money to cover transport costs to access TB diagnostic facilities,” Dr Sandy said.

There were no figures for the treatment success rate in 2007. In 2006, treatment success rate was 60 per cent, showing a deficit of 25 per cent from the 85 per cent target set by WHA.

Due to previous funds from the Global Fund to fight AIDS, TB and Malaria (GFATM), work on scaling up the National TB Programme (NTP) had already begun across the whole country.

“In the past two weeks, the government delivered about 260 microscopes and TB diagnosing reagents kits throughout the country. Training of 61 laboratory trainees has also begun and we are expecting to train at least 180 by the end of the year,” Dr Sandy said.

However, these efforts to control TB maybe short-lived if the Global Fund fails to disburse the rest of the funds from the approved grants.

According to Dr Sandy, the Fund still hasn’t disbursed part of the funds from previous approved grants.

It is clearly evident that Zimbabwe needs to radically step up its TB control and TB-HIV collaborative activities.

Keywords: 3rd Stop TB Partners Forum AIDS Brazil 2009 drug resistance extensively drug-resistant Global TB Control report HIV M/XDR-TB MDR-TB multi-drug resistant Rio 2009 TB tuberculosis WHO XDR-TB Zimbabwe

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