Worry over TB-Aids infection

THE extent of tuberculosis and HIV co-infection rates in South Africa has firmly placed TB on the agenda of the South African National Aids Council.

This after studies have shown that in some parts of the country, like in Khayelitsha in Western Cape for example, about 73 percent of HIV-infected people also have TB.

The South African National Aids Council (Sanac) took a decision to include TB as part of its mandate after a World Health Organisation (WHO) review in 2009 of South Africa's national TB control programme. The review found that the levels of TB and HIV co-infection were enormously high. About 70percent or more of TB patients in some parts of the country were also found to be HIV-positive.

Following that report, it was decided that all of the country's collaborative responses to TB and HIV would fall under the oversight of Sanac. That means that Sanac will be responsible for developing and coordinating policy and practice to deal with the dual epidemic.

"What we've got now is experts on TB represented on the Sanac structures, the treatment task team of Sanac now includes the TB-HIV experts. In the last year what we also did was manage to get guidelines for the public sector on how to integrate TB and HIV collaborative activities. "What we also have is (a) guideline that was approved by the International Labour Organisation on the management of TB and HIV in the workplace,'' says Sanac's CEO Dr Nono Simelela.

Simelane says TB has taken priority at Sanac, with suggestions being made that the organisation should change its name to reflect the enormity of co-infection levels in South Africa.

"There have been proposals at the plenary level to look at whether we shouldn't actually be having a South African Council on HIV and Tuberculosis. And I really believe that that is the route we need to take.

"South Africa should consider itself to be having a TB-HIV epidemic instead of just Aids because I think Aids is something we are managing. We're getting more and more people on treatment. So, we will see less and less of Aids, but higher levels of co-infection,'' she says.

One of Sanac's priorities is to prevent TB infection in HIV-positive people. Current policy is that HIV-infected individuals who don't have TB be given six-month prophylactic treatment of Isoniazid or INH to prevent them getting the bacterial infection. She is concerned that the distribution and uptake has been very low.

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