Poor TB controls in many clinics‚ allowing disease to spread to other patients‚ survey finds

23 March 2017 - 17:57 By Katharine Child
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TB. File photo
TB. File photo
Image: Gallo Images/iStockphoto

A spot survey of clinics across the country showed tuberculosis infection control was exceedingly poor meaning patients can contract the infectious disease while waiting in clinics for medical treatment.

TB is the biggest killer of South Africans‚ although the underlying cause for most TB deaths is untreated HIV. About 75% of people who died of TB locally had HIV. About 450 000 people get TB in South Africa each year.

The Treatment Action Campaign sent members to clinics around the country to measure TB control measures.

Of the 158 clinics assessed‚ 114 were deemed as "red"‚ meaning not enough was done to stop the spread of TB in these crowded place. "We have the knowledge and the tools to stop the spread of TB‚ but we aren’t using them‚" said Sibongile Tshabalala‚ TAC Deputy General Secretary.

"Instead what we see on the ground are horrendously packed clinics with all the windows shut. We don’t see any posters telling people to cover their mouths if they cough or sneeze. We see people with TB symptoms sitting among those without‚ coughing and not being offered masks or tissues."

The Treatment Action Campaign's concern is not unfounded. TB is spread in crowded locations including schools‚ prisons and clinics.

Work on how people in KwaZulu-Natal contracted extremely drug resistant TB was recently published in the New England Medical Journal. Local and international scientists analysed the genotypes of the XDR-bacteria and linked infections scientifically and were able show most people got this deadly TB from people in their household‚ but a fair amount contracted it in hospitals.

Members from TAC branches in the Eastern Cape‚ Limpopo‚ Mpumalanga‚ Free State‚ Gauteng‚ KwaZulu-Natal‚ and Western Cape visited clinics in their neighbourhoods this month and then answered the following questions:

1. Are the windows open? 2. Is there enough room in the waiting area? 3. Are there posters telling you to cover your mouth when coughing or sneezing? 4. Are you seen within 30 minutes of arriving at the clinic? 5. Are people in the clinic waiting area asked if they have TB symptoms? 6. Are people who are coughing separated from those who are not? 7. Are people who cough a lot or who may have TB given tissues or TB masks?

When the answers were "no" more than three times‚ the TAC decided the facility was red.

The facilities with great TB control measures were: Brealyn Clinic (EC)‚ Daveyton East Clinic (GP)‚ Eshowe Hospital (KZN)‚ King DiniZulu Clinic (KZN)‚ Letitia Bam Day Hospital (EC)‚ Mjejane Clinic (MP)‚ Mpoza Clinic (EC)‚ Nelspruit Community Health Centre (MP)‚ Nkensani Gateway Clinic (LP)‚ Nolungile Youth Clinic (WC)‚ Nomzano Clinic (EC)‚ Qaukeni Clinic (EC)‚ Senyorita Clinic (FS)‚ Site B Clinic (WC)‚ Thelkwane Clinic (MP

"While we stress that this is by no means a scientific survey and the results are not generalisable to the rest of the public healthcare system‚ it does suggest that infection control is a significant problem in many public sector health facilities.

"As a result‚ we demand that government carries out a full audit of all public buildings in South Africa‚ including schools‚ clinics‚ hospitals‚ correctional facilities and home affairs facilities‚ to assess whether sufficient TB infection control measures are in place‚" said Yawa.

It is World TB on Friday 24 March.

- TMG Digital

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