SOUTH Africa will ramp up home delivery of medicines to patients and expand the use of chest X-rays for tuberculosis (TB) screening in communities as it looks to contain new infections since the COVID-19 pandemic severely disrupted health services, the health minister said yesterday.
Designated by the World Health Organization as a high burden country, South Africa registers around 60,000 deaths from TB each year, making it the country’s leading infectious disease killer closely intertwined with one of the world’s highest rates of HIV/Aids.
As COVID-19 pummelled South Africa since first being detected in March last year, many TB clinics in poor communities closed temporarily due to contamination. People were banned from public transport during lockdown restrictions while others stayed indoors for fear of catching the coronavirus.
A disease of the poor, TB is caused by the Mycobacterium tuberculosis bacteria and is spread easily in shantytowns where a simple cough helps fuel the preventable disease.
“The impact of the COVID-19 pandemic on health services and TB in particular is well documented. A lot of effort will be required to mitigate the negative impact of COVID-19,” Health Minister Zweli Mhkize said at the release of a national TB prevalence survey carried out between 2017 and 2019.
South Africa saw a 48% plunge in diagnostic testing and a 33% decline in laboratory-confirmed positive cases between February 3 and May 3 2020, said the National Institute for Communicable Diseases.
Between April 1 and July 31 last year, as a result of COVID-19, an estimated 308,000 fewer TB Xpert tests were conducted, and 17,700 fewer positive samples detected, the NICD said in September, just before a deadlier second wave of coronavirus infections struck.
“We should also consider expanding TB screening and testing services in order to identify missing TB patients,” said Joe Phaahla, the deputy minister of health.
The WHO said last year the global number of TB deaths could increase between 200,000 to 400,000 in 2020 alone if health services are disrupted to the extent that the number of people with TB who are detected and treated falls by 25–50% over a period of 3 months.
In its Global TB report released in October, the WHO said India, Indonesia, the Philippines and South Africa – four countries that account for 44% of global TB cases – experienced large drops in the reported number of people diagnosed with TB between January and June 2020.