Health care-workers in South Africa are battling to contain the airborne, deadly bacterial infection, which is resistent to nearly all antiobiotics which used to be effective against TB. There is no vaccination against it and no cure. South Africa's new health minister Barbara Hogan has recently switched the country's health-care policies of isolating infectious patients for long periods of time by locking them away in hospitals, to trying to treat and monitor them at home. The country's health care system is being overwhelmed by XDR-TB patients who usually die within twenty days of admission, although many can linger on with some very expensive drugs for longer periods.
Patients In Tugela Ferry, where the new programme is being tested, say they are grateful of the change, and noted that was is a great improvement over the enforced regimentation at the country's TB hospitals.
KwaZulu Natal, the sleepy, tropical province on South Africa's Indian Ocean coast, is the epicenter of the worldwide epidemic of a new drug-resistant tuberculosis.
The South African government's battle against the disease has also raised troubling questions in the world-wide health care community because other countries are also gearing up to deal with this deadly new infection, for which no vaccine can be found and very few drugs are still able to cure.
Quarantine or treatment at home?
The most pressing problem for the rest of the world is to how best to limit its spread, WHO says.
And with the number of XDR-TB cases now extending to more than 48 countries in the world, governments are increasingly debating whether sufferers should be forcibly quarantined to prevent infecting others - as they are in the USA and still in many provinces of South Africa -- or treated at home, with the family members educated about contamination by teaching them barrier-nursing hygiene techniques.
Ordinary tuberculosis has been killing people for at least 5,000 years. However over the past 20 years, the lung disease has become steadily resistent to just about every antibiotic treatment in the world, and causes the deaths of 1.7 million people each year, the largest number in Southern Africa.
Today, the World Health Organization
estimates that there are 500,000 new MDR-TB cases each year, causing 110,000 deaths. And 7 percent of those cases may actually be XDR-TB - it's very difficult to test.
Development of drugs to combat the new strains of TB is slow. The last TB drug came to market more than 35 years ago, and the few promising candidates in clinical trials are five to 10 years away.That is why South Africa mainly still isolates its Multiple-drug-resistant and Extreme Drug Resistant TB patients.
Very vulnerable 5.7million HIV-AIDS sufferers:
Fearful of allowing such a highly infectious airborne disease to run unchecked among its 5.7 million HIV-positive people who are especially vulnerable to TB, South Africa quarantines most of these patients in hospitals surrounded by razor wire.
However now the new health minister, Barbara Hogan, has decided to change this policy and find a more humane way to treat these patients so that they can still remain with their families.It remains to be seen whether this will spread the epidemic even more in southern Africa.
One of the main worries among many medical experts in South Africa is that with the forthcoming World Cup 2010 expected to draw some 350,000 foreign football fans and tourists, they may also unwittingly take an unwanted souvenir along from the country -- namely the airborne bacterial disease XDR-TB.