Moin zusammen.
Super-TB+AIDS epidemic explodes in South Africa
'We are sitting on a time-bomb - but is anybody listening? '- desperate SA doctors
Augst 5 2008 -- But will the international AIDS-conference deal with this crisis which is overwhelming South Africa's crumbling health-care system? The international health-care community still deal with AIDS as a stand-alone disease - yet in South Africa, AIDS has mutated with Tuberculosis, becoming an airborne monster: deadly within a month yet takes six weeks to diagnose; untreatable with present drugs -- and no effective vaccine exists against it...
Video - Voice of America:
http://www.youtube.com/watch?v=INdBNgOc5ls
Video - Virgil Walsh, BBC:
http://www.bbcworld.com/Pages/ProgrammeFeature.aspx?id=106&FeatureId=765
How much longer can the world 's tourism- and sports-world, for instance, still go on ignoring this growing international health threat - with hundreds of thousands of international soccer fans expected to travel there for the FIFA World Cup in 2010 in South Africa?
http://www.telegraaf.nl/binnenland/1619242/__Koenders_hamert_op_aids-preventie__.html
Journalist Anso Thom reported in the Cape Times in July 2008 that 'an explosive situation is developing at all of South Africa's hospitals and health clinics'.
5,4-million AIDS/HIV patients also co-infected with Tuberculosis
According to Medicines Sans Frontieres, South Africa has an estimated 8-million people with AIDS/HIV - and 67 % of them (5,4-million) are also co-infected with Tuberculosis.
They base this assessment on their findings at the combined TB+AIDS clinic they operate at Khayelitsha, WCape. In the rest of SA, tuberculosis and AIDS co-infected patients have to go to two seperate clinics for their treatments and health assesments.
And the doctors, nurses, kitchen employees, drivers and laundry-workers dealing with this rapidly-growing army of (increasingly angry) patients are also rapidly being infected with super-tuberculosis.
Dire warnings were issued last month by many of these workers that many colleagues have already died recently -- within just a month of infection with extremely-drug-resistant tuberculosis from their patients -- mainly because the health authorities are completely ignoring the need for countrywide infection control.
Due to the present political turmoil which has left the country 's leadership in limbo and indecisive, at least two provincial health departments - the Eastern Cape and North West provinces -already are so badly managed that they are nearly defunct - leaving thousands of underequipped, underfunded health workers out in the cold, combating a rapidly-spreading killer-epidemic all on their own.
Picture left: this child was recently photographed by the BBC at a crowded TB clinic in the Western Cape -- where infected and healthy people sit in the same waiting room and thus quickly infect one another. Patients are not given any infection-control warnings and not even masks are worn by such patients anywhere in SA. This dangerous lack of infection-control is routine, health workers warn.
140 TB patients all trying to deliberately cough on you at the same time...
One counsellor working in the Eastern Cape described the situation at the TB hospitals as 'out of control.'
"We see patients deliberately trying to infect health workers when they become angry at being locked up to prevent them from spreading the infection," she said. "And when things get out of hand and you sit with them to hear their grievances, you have 140 patients all deliberately coughing their bacillae all over you at the same time."
A bus driver transporting patients was infected with TB, a chief nurse died of MDR-TB, five staffers treating 16,000 prisoners were infected, 100 staffers at one KZN hospital got TB;
These were only some of the frightening tales told by delegates at a 'skills' session presented by the SA HIV Clinicians Society at the national TB conference in Durban . Worried nurses, bus drivers, and laundry and kitchen staff said that they were becoming very frightened of dealing with these patients, as their colleagues and family members were being killed at a huge rate by the killer-lung-infection contracted through their jobs. In South Africa, most of the XDR-TB deaths occur among people with the AIDS-virus.
And the authorities are completely ignoring their plight, health workers complain.
"'Poor infection control measures, such as poor ventilation, the failure to provide masks, and the forced institutionalisation of TB patients were largely to blame," delegates said.
Natalie Beylis of the National Health Laboratory Services, said that two of the 54 people who died when extensively drug-resistant (XDR) TB was first identified at Tugela Ferry, KwaZulu-Natal in October 2006 were health workers.
Chief nurse died of Super-TB: but staff get no masks...
A health worker employed at an HIV clinic at one of Johannesburg's large hospitals said it had taken her two months to get the hospital managers to buy a box of masks after the chief nurse was infected with MDR TB and died very quickly.
A doctor from Chris Hani Baragwanath Hospital said five staff members treating more than 16,000 inmates at a nearby prison had become infected over the past two years, two now suffer multiple-drug-resistant Tuberculosis, which can be treated with only two available drugs.
TB-vaccine is useless
XDR-TB has no cure at all -- and even people who have been vaccinated with the only available TB vaccine, die from super-TB. This once so effective vaccine - which brought Tuberculosis under control all over the world, now is becoming practically useless.
A bus driver who for years had been transporting patients in a poorly-ventilated bus from the hospital to a step-down facility next door was also recently infected with TB, she said.
The doctor said highly-infectious MDR-TB patients were being taken to the Sizwe TB hospital 40km away inside ambulances and buses that were in no way equipped to protect any of the staff accompanying them. Health workers in SA have to be vaccinated against TB - but this is giving them no protection against XDR-TB at all.
100 staffers infected in KZN:
Another doctor from a hospital in rural KwaZulu-Natal said 100 staff members, including nurses, laundry workers, kitchen workers and cleaners, had contracted TB since 2000.
'Super-TB patients sit in the rear of the bus - that's the
only infection control...'
Another doctor from this hospital said 200 MDR TB patients were sent every month to the King George Hospital in Durban on an overnight bus. "They are transported in the same bus as patients going to see other specialists at the tertiary hospitals, including HIV-positive patients," the doctor said.
"The best infection control we could put in place was to put the MDR patients at the back of the bus."We are really sitting on a time bomb. We know about it, but we need to ask whether anyone is listening out there.
"We need to put infection control more firmly on the agenda. We are the ones getting infected, but I remind myself every day not to think about it too much or I wouldn't be able to continue with my job."
Health nurses are often HIV-positive already...
A nurse working at an MDR centre in the Eastern Cape said it was becoming increasingly difficult to recruit staff. "Health workers are often HIV-positive and there is no way you can expose them to the risk," she said.
Police often have to be called in to protect doctors assessing whether Super-TB patients could go home, the counsellor said.
All the health workers complain that countrywide, infection control measures 'poor or totally absent'. Often, where ventilation systems or UV lights had been installed, these were out of order or inadequate.
TB is just ignored:
"I find it laughable that when we have one meningococcal meningitis case then there is an uproar," a doctor said. The patient is placed in a side room and prophylaxis is given to everyone who comes into contact with the patient, but TB is just ignored." Delegates have called for the conference to take a strong stand on the urgent need for infection controls.
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SOURCES:
Overworked doctors can't contain Super-TB in Humansdorp -- health officials warn
Humansdorp district hospital manager Johan Wiggill warns that 'things were becoming totally untenable for the hospital, there are only three doctors left who have to work an average 120-hour week. The mobile TB-clinic treating hundreds of rural patients hasn't been out in the field to distribute medication since June 2008 as some 50% of the nursing posts were vacant. And the East-Cape health department which arranges new appointments hasn't answered its telephones for weeks.
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Medicines Sans Frontieres Khayelitsha:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040162
http://news.bbc.co.uk/2/hi/africa/934435.stm
http://www.int.iol.co.za/index.php?set_id=1&click_id=125&art_id=vn20080703054613602C836123
XDR-TB epidemic in SA hospitals 'out of control' warn health workers
'Perfect storm’ of AIDS plus killer-TB lashes SA mineworkers
Recent report by Fergus Walsh of BBC-TV:
http://news.bbc.co.uk/player/nol/newsid_7260000/newsid_7268200/7268204.stm?bw=nb&mp=wm&news=1&nol_storyid=7268204&bbcws=1
http://www.plusnews.org/report.aspx?ReportID=79107
http://www.abkhazia.com/content/view/912/67/
Super-TB in SA - could it become a worldwide health threat? News summaries:
http://groups.msn.com/crimebustersofsouthafrica/alertsonhealth.msnw?action=get_message&mview=0&ID_Message=3166&LastModified=4675670165285815775
SA doctor cleared for showing AIDS as cause of death on death-certificate
April 8 2008 - Dr Wagner, former chief pathologist of the Free State and Solidarity trade union member, was cleared of any wrongdoing by the South African Health Professions Council (SAHPC) for showing AIDS as a cause of death on a death-certificate, for which he had been arrested.
World Health Organisation XDR-TB info:
http://www.who.int/tb/challenges/xdr/en/index.html
http://censorbugbear-reports.blogspot.com/Anhusten reicht im Falle eines Falles schon aus.
Gruß, Michael