TB Treatment Strategies in South Africa

Given the treatment/hospital quarantine strategy used in South Africa (outlined in the full article), innovative treatment services may encourage more people with TB symptoms to come forward for treatment. Treatment approaches such as this one in South Africa via Doctors Without Borders may be useful in other high-burden and MDR-TB endemic areas around the world.

"...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..."

Full article at:
http://www.nytimes.com/2009/07/29/world/africa/29safrica.html