3. MDR TB Conference Paper June 2014

17-Jun-14
A rural Community Based Organization
Identifies MDR TB Cases in School,
Household and Community in Uthungulu
District - KZN
Fikile Dlongolo, Nothando G. Khumalo,
Evelyn Mhlope and Andronica Ratshefola
URC
Outline of the Presentation
•
•
•
•
•
•
•
Background
Interventions
Results
Results Analysis
Challenges
Conclusion
Acknowledgements
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17-Jun-14
Background
 MDR TB is on the rise in South Africa since the
implementation of GXP,
 The worst affected province is KwaZulu Natal with
over 5000 cases diagnosed in 2013,
 uThungulu district is the second highest district
registering MDR TB patients in KZN,
 In 2012 the district registered 386 MDR TB cases
and 434 in 2013
2013,
 In 2013 Amakhumbuza Community Centre was
funded by USAID TB Program to increase demand
and access for TB services at the community level,
Background continues…
• Amakhumbuza Community Care Givers visit local
h l tto provide
id TB and
d HIV education
d
ti and
d thi
schools
this iis
followed by screening learners and teachers for TB
symptoms
• In addition to this the organization provides
injectables and DOT Support to twelve MDR TB
patients within Matshana area.
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Interventions
 Visits to local schools are part of intensifying TB case
fi di iin th
finding
the community,
it
 Learners and teachers are accessed during morning
assembly,
 Following the TB/HIV awareness education the
organization is given scheduled access to screen
learners for TB during Life Orientation classes,
 In October 2013, 80 learners were screened for TB
using TB symptomatic screening tool,
 Sputa was collected from presumptive TB suspects
and sent for GXP testing.
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Results
 Of the 80 learners tested one was confirmed with MDR TB,
 8 Household contacts of the index case were followed up,
screened
d and
d ttested
t d ffor TB,
TB
 TB contact screening was also extended to 139 community
members and immediate neighbors to the index case,
 The grandmother to the index learner and a community
member (neighbor) were diagnosed with MDR TB,
 Contact screening
g was conducted in the classroom wherein
the learner was schooling, another sixteen year old was
diagnosed with MDR TB,
 All were referred to the DR TB decentralized site
where
h
ffurther
th iinvestigations
ti ti
were d
done and
d allll
patients were commenced on MDR TB treatment.
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Results Analysis
Challenges
 Stigma,
 Infection Prevention and Control within schools and
households (overcrowding and unsatisfactory
ventilation),
 Long duration of MDR-TB treatment,
 High TB/HIV co-infection
co infection rate, and
 High pill burden.
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Conclusion
 These findings indicate that the role of CBOs in the
di
diagnosis
i off MDR TB is
i significant,
i ifi
t
 There is a need to further engage communities to
deal with stigma associated with TB disease, and
 In schools infection prevention and control should be
advocated.
Acknowledgements






USAID TB Program for providing funds,
DOH,
DOE,
URC USAID TB Program staff,
Amakhumbuza CBO staff, and
Matshana community members
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Together We Can Stop TB
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