Zim records decline in tuberculosis (TB) cases

CASES of tuberculosis (TB) infections have declined significantly in the past three years owing to improved government interventions, a cabinet minister said last week.

Report by Tatenda Chitagu and Dalphine Tagwirei

Speaking at the World TB Day commemorations in Masvingo last week, Health and Child Welfare minister Henry Madzorera attributed the decline to improved access of anti-retroviral therapy to People Living With HIV and Aids (PLWHA) as well as successful HIV care and treatment programmes in the country.

TB is the leading cause of death among PLWHA.

"We have recorded a stable and consistent decline of the total TB notifications over the last three years.

The improved coverage of ART [anti-retroviral therapy] certainly has a role to play in the decline of cases noted," he said.

"The universal access of ART has greatly reduced the number of people with compromised immunity, thus reducing the number of new cases of TB."

The World International TB Day is commemorated every year on March 24.

Madzorera said in 2010, Zimbabwe recorded 47 000 TB notifications and this fell down sharply to 41 000 in 2011.

Last year, the notifications further went down to 38 367 in 2012.
But it appeared Madzorera was also not sure of figures from his ministry.

"Indeed the Ministry of Health officials must do the usual due diligence exercise of verifying that these results are not fictitious, but in the meantime, let us celebrate our progress," said Madzorera.

In a separate interview with The Standard, deputy minister of health, Dr Douglas Mombeshora said even multi-drug resistant TB (MDR-TB) strain was no longer a big cause for concern in the country as there was adequate medication for first line therapy of the disease.
He said most people infected with TB either had poor compliance to the drug or had an incomplete course intake.

"The problem in Zimbabwe is on diagnosis, if people get tested early and health centres are near their homes, then many lives are saved," he said.

As the world commemorates the World TB Day today, Médecins Sans Frontières (MSF) last week released a manifesto in a move to curb MDR-TB titled, Test me, Treat me.

This comes in the wake of Zimbabwe fighting hard to eliminate TB, hence MDR-TB is being fought tooth and nail as it is a lethal killer.
This can be attested to by Taruva Muvhuni (39), a father of three from Epworth, who was infected with TB in 2010 and is no longer taking MDR-TB drugs.

"When I started taking medication of first line therapy of TB, I was asked to stop taking medication because traces of TB could not be found in my phlegm and I stayed a month without any medication," said Muvhuni.

"After diagnosis of MDR-TB, the main challenge was the mountain of pills. I had to take daily injections for eight months and pass granules. These have side effects like loss of hearing, numbness, fatigue, mind-loss as well as vicious anger."

He added: "After five-culture sputum examinations, the tests came out negative on traces of TB and on Valentine's Day of this year I was exempted from continuous medication."

The testimony is one of many in Epworth, where MSF is supporting the treatment of large numbers of TB patients.

However, Mombeshora contradicted his boss on the issue of drug resistant TB, saying the strain was still a great threat.

"Drug resistant TB is now a global public health threat and Zimbabwe has not been spared . . . we are going to experience an artificial epidemic of drug resistant TB," Mombeshora warned.

"There is no prospect of eliminating TB from Zimbabwe until every HIV-positive patient is checked for TB each time they get into contact with the health delivery system, and every TB patient is tested for HIV," he said.

Cases of drug resistant TB doubled last year from 156 in 2011 to 244 cases, he said.