High death rate among Cape XDR TB patients
Thirty three of the 82 patients with extensively drug-resistant (XDR) TB admitted at the Brooklyn Chest Clinic in Cape Town have died and only four have been cured.
This was revealed by Dr Sweetness Siwendu, TB specialist at the clinic, at the national TB conference in Durban yesterday.
Two-thirds of those who died did so before they had started treatment for XDR while the remaining one-third died while on treatment.
Dr Siwendu identified the Southern and Tygerberg sub-districts in the Cape Town metro as the two areas with the highest rate of patients defaulting on TB treatment, and said substance abuse was partly to blame for this.
Almost all the XDR patients (93%) had multi-drug resistant (MDR) TB and were resistant to the two most common first-line TB drugs, before developing XDR TB, which is resistant to both the first-line and second-line drugs.
Meanwhile, a study of multi-drug resistant TB patients in Uitsig in the Tygerberg sub-district found that patients with MDR TB were far more likely to die if there were others with MDR TB in their household.
‘In the 48 households with single MDR patients, there were 16 deaths but in 11 households with multiple MDR TB patients, there were 20 deaths,’ Susan van Zyl from the Desmond Tutu TB Centre told the conference. Her study looked at all cases of MDR TB in Uitsig over the past nine years.
Reinfection was a real danger in these households and patients in these households tended to have poorer treatment adherence, said Van Zyl. High levels of alcohol and drug use was reported among all the MDR patients.
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