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facts that MRC researchers have found |
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XDR-TB to be tackled extensively
 Isolated wards are being erected in most of the provinces in South Africa to facilitate the management of patients with extensively drug resistant tuberculosis (XDR-TB). The reason for these special wards is to prevent XDR-TB patients from getting in contact with other TB patients.
Senior scientist at the TB Epidemiology and Intervention Research Unit Division of the Medical Research Council, Dr Martie van der Walt says XDR-TB can be acquired when a patient is re-infected with a second drug-resistant TB strain or due to the inadequate treatment of a drug resistant TB infection. At the 15th Conference on Retroviruses and Opportunistic Infections that was held in February 2008 in Boston in the USA, Mark Mascolini presented researchi which illustrated that re-infection with a second mycobacterium, and not improper anti-TB therapy, accounted for all 17 initially diagnosed cases of multi-drug resistant (MDR) or XDR-TB in Tugela Ferry in KwaZulu-Natal. TB isolates were collected before and after evolution to MDR or XDR TB. Medical staff at the Tugela Ferry clinic then discovered that the genetic make-up of the second set of samples is of a different TB strain than that of the first samples. All 17 people who were initially diagnosed with MDR or XDR were in the hospital between the initial diagnosis and the second follow-up culture. Dr van der Walt says patients who have XDR-TB should access their health system as soon as possible. “By taking the medication you will then become non-infective and thereby prevent the infection being transmitted to others”.
When patients with regular tuberculosis do not follow their treatment routine for the full 6 months, they can develop MDR-TB. This multi-drug resistant TB strain can be cured in 9 months, but if the treatment regime is not followed properly, MDR-TB can develop into XDR-TB. Dr van Walt says patients with XDR-TB would have to take treatment for up to 36 months to be cured. “For the first part, patients [with XDT-TB] need to be in hospital, because they get injections every day and once they are not infective anymore, they can be discharged and take their treatment at home.”
People living with HIV have an increased chance of acquiring tuberculosis. Since HIV weakens the body’s immune system TB could then develop. Patients usually receive treatment for TB first before anti-retroviral therapy is introduced.
According to a studyii, iii by Adrian R Martineau et al., vitamin D supplementation appears to have a beneficial effect on the treatment of tuberculosis and appears to enhance the immunity to tuberculosis. More research is currently being conducted in this field.
More than R400 million has been made available to strengthen the Department of Health’s response to MDR and XDR-TB. Minister of Health, Dr Manto Tshabalala-Msimang said at a Social cluster briefing in parliament they are determined to ensure that more than 3000 health workers are trained in TB management during the course of 2008.
by Janus Snyders
Web and Media Technologies Division
MRC
References
- Mascolini M. “Reinfection explains all MDR/XDR TB cases with HIV at South African Flashpoint” 15th Conference on Retroviruses and Opportunistic Infections. February 3-6, 2008. Boston. Abstract 143
- Martineau AR, Wilkinson RJ, Wilkonson KA, Newton SM, Kampmann B, Hall BM, et al. (2007). “A single dose of vitamin D enhances immunity to Mycobacteria”. Am J Respir Crit Care Med. Doi:10.1164/rccm.200701-007OC.PMID 17463418
- Wikipedia, the free encyclopedia. http://en.wikipedia.org/wiki/Tuberculosis_treatment
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