HIV/TB Co-infection Drives TB Mortality In Matebeleland

MATEBELELAND province currently has the highest TB deaths standing at 19 percent as of 2018 owing to increased cases of HIV/TB co-infection, a health official has said.

By Michael Gwarisa in Bulawayo

In an interview on the side-lines of the World TB Day commemorations conference in Bulawayo which also marked the presentation of Zimbabwe’s first national TB patient cost survey which was done by the Ministry of health in collaboration with The Union through funding from USAID, Deputy Director Aids and TB Unit in the Ministry of health, Dr Charles Sandy said even though TB Infection cases were dropping, more still needed to be done to address the costs aspect of treatment and care.

“The HIV and TB co-infection for Matebeleland is currently at 91%, so that in itself increases the risk of people dying because of dual infection especially if the dual infection is not managed timely and appropriately.

“We know that in this region of the country, people have to travel vast distances to get to a health facility and that could be one of the reasons why it is like that. The underlying prevalence rate for HIV in this part of the country is also very higher than the northern part,” said Dr Sandy.

He added that the issue of massive cross boarder activity was also a major cause for concern in the province as it has resulted in many falling sick and failing to access medical attention in foreign countries since they would have illegally migrated to other countries.

Matebeleland is a high burden zone for infections diseases such as TB which is, Multi Drug Resistant TB and HIV with more cases coming in from Beitbridge and Gwanda for the period of 2016 to 2018 with the least notifications coming from Umzingwane.

According to the survey findings, TB patients were currently facing catastrophic costs in accessing treatment with indications that a number of families end up destitute.

Presenting on the findings of the survey, World Health Organisation (WHO) said 90 percent of MDR TB patients faced catastrophic costs compared to 79 percent of DS-TB patients.

“Half of TB patients reported an annual income below US$1, 800 prior to US$888 after TB diagnosis. On average, DS-TB patient lost about a third of their pre TB income, while a DR-TB patient experienced a loss more than 90 percent.

“Over 70 percent of TB patients were living in poverty before TB diagnosis. This is the same proportion as among Zimbabwe’s general population. However, payments for TB care led to significant increase in the proportion of households that live below the poverty live below the poverty line to 81 percent.”

Some of the costs TB patients incur include transport costs, x-ray costs, non-medical costs, medical costs nutrition costs indirect costs among others.

Meanwhile, The Union Zimbabwe Country Director, Dr Christopher Zishiri said their partnership with the ministry of health in the national TB response program dubbed the End TB Challenge program had beard fruits as evidenced by the decline in TB cases in the past few years.

“We prioritise high risk groups in our TB screening campaigns, these include artisanal miners, the elderly, the children and health care workers to ensure that healthcare workers are screened for TB because they are not immune to TB and they are the ones who see the patients before they are actually screened.

“The childhood TB is another issue which we supported in terms of piloting the intervention in Makoni in terms of rolling out is under way this has been found work actually in terms of increasing the number of notifications by 50 percent of children, we have rolled out the package in 21 low notifying districts to increase the diagnosis of TB in children,” said Dr Zishiri.





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