Mkhize highlights the way forward for SA’s TB response

Recommendations stemming from a high-anticipated Tuberculosis Prevalence Survey have stipulated that more needs to be done to increase access to screening and testing services through outreach programmes.

The recommendations seem to correlate with interventions taken to curb the spread of COVID-19 in South Africa.

The report, released on Friday by the Human Sciences Research Council, recommended that access to TB screening and testing services should be increased using mobile testing and X-ray facilities, specifically targeted to rural populations.

It recommended that people living with HIV be routinely tested, as well as household TB contacts and people previously treated for TB, irrespective of symptoms.

The use of chest x-rays for TB screening at facility and community level, and the use of existing diagnostic tests such as Gene-Xpert, was also motivated for.

Speaking on behalf of the HSRC, Dr Sizulu Moyo said South Africa should scale up access to treatment for TB infection to all eligible people living with HIV, all household contacts and people living with silicosis.

Delivering closing remarks after the presentation of the report, Health Minister Dr Zweli Mkhize said as a high burden country, South Africa continues to battle a TB epidemic.

“In addition, our rates of drug resistant TB, though declining, continue to pose a public health risk. The continued prevalence of TB has been mainly driven by the concurrent HIV epidemic, however, much has been gained in reducing the burden due to our high coverage with antiretroviral treatment,” he said.

“Access to health services is a constitutional right. As government, our commitment is to realize a long and heathy life for all our citizens. This survey was undertaken to ensure that our services are responsive to the lived experience of our communities. There are lessons on community engagement and multi-sectoral partnerships that we can learn from provincial experiences, which we can take to scale.”

The report found that there are many people with undetected TB in communities, and that people with TB symptoms delay to seek care. It also found that a higher proportion of HIV negative people have asymptomatic TB than people living with HIV.

This has been a key finding which will require a shift in the way we achieve proactive health seeking behaviour.  Previously, we focused on symptomatic patients and those living with HIV. We now need to encourage everyone to screen and test for TB to achieve elimination,” Mkhize said.

“What is encouraging is that we have established a solid foundation for resilient emergency response systems. By implementing the recommendations, we will reinforce and elevate some of the key strategies we have learnt from our COVID-19 response.”

Mkhize said COVID-19 has shown us many innovative ways of providing health services in an integrated manner for efficiency.

These should include, he said:

  • The leveraging of digital technologies for TB screening, contact tracing and treatment adherence.
  • The TB Health Check App which has been developed and can be accessed by dialing *134*832*5# or send ‘TB’ to +27600123456 on WhatsApp.This App provides an easy way for everyone to screen themselves for TB.
  • Home delivery of medicines for patients by community health workers and inclusion of TB medicines in the CCMDD system.
  • Integrating TB and COVID-19 testing using Gene Xpert technology.