More research needed on TB treatment defaulters

Manicaland, Midlands and Chitungwiza provinces recorded the highest number of people who defaulted on tuberculosis treatment, according to the health ministry.

In his National TB Control Programme overview, the Deputy Director in the AIDS/ TB Programmes, Charles Sandy, said although there was considerable improvement on the treatment outcome, the number of defaulters called for more research.

Manicaland recorded nine percent of TB patients who defaulted on treatment as of the third quarter of 2013 while Midlands and Chitungwiza recorded five and four percent respectively.

“The national target is below two percent. Matabeleland North is doing well because it recorded a decline from three percent to two percent and Harare and Bulawayo are doing well on this indicator,” said Sandy.

Zimbabwe is one of the 22 high-burden TB countries, accounting for 80 percent of new cases in the world annually.

The proportion of all TB patients tested for HIV was 61 percent, of whom 78 percent were HIV-infected, according to statistics released by the Population Services International. Challenges to TB control are multifaceted, ranging from socio-economic factors, limited access to convenient TB diagnostic centres and lack of sensitive and rapid TB tests.

Sandy said there were a number of gaps that needed urgent redress in the fight against TB in Zimbabwe. “Stigma, knowledge, attitude, demand and rights are some of the gaps that need to be addressed to ensure that government and implementing partners’ interventions realise the intended goals,” he said.

Commenting on what Chitungwiza referral hospital was doing to follow up on the patients who were defaulting on treatment, an official who spoke on condition of anonymity said they had failed to locate the defaulters.

“We tried making follow ups on the defaulters on the addresses that they had given, but it could be that they moved to other locations or they deliberately gave us wrong addresses,” he said.

A new study by Canadian researchers from the University of Toronto, linked the rise of TB in Zimbabwe during the socio-economic crisis of 2008-9 to widespread food shortages.

A senior author of the study, assistant professor Michael Silverman, said the study established that TB in Zimbabwe was associated with the national economic decline.

“Zimbabwe may have been predisposed to TB due to the presence of a large HIV-positive people who were particularly vulnerable to the effects of food shortages, which led to malnutrition and further damage to already weakened immune systems,” said Silverman.

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