City Welcomes Delegates to International Conference on Lung and TB Disease

The City of Cape Town is honoured that the International Union Against Lung and Tuberculosis Disease (IUALTD) has decided to host their annual International Conference here. The conference, which will be attended by 3000 delegates, starts at the Cape Town International Convention Centre on Thursday, 8 November.

The conference theme - "Confronting the challenges of HIV and multi drug resistant TB cases in TB prevention and care" - is not only highly relevant to those responsible for health care in Cape Town, but also to their colleagues in the rest of South Africa and the continent. The City has, amidst resource constraints and on a daily basis, to deal with the burden of HIV/AIDS and TB co-infection and its medical, health, social and economic consequences. Both of these issues pose a serious threat to its efforts to bring the TB epidemic under control.

Cllr Martin Fienies, Mayoral Committee Member for Health, expressed the hope that the Conference would address the constraints to effective prevention and care while taking into consideration broader political, economic and sectorial issues. "We look forward to candid debate on the challenges we jointly confront, debate that will contribute to a better understanding of how we can ensure more effective, efficient and sustainable services, interventions and programmes", Cllr Fienies said. "Such programmes and interventions must be built on, and benefit from, solid context-sensitive research, and be geared towards better health service delivery and the further development of staff in all countries".

City Health will be sending a number of staff members to the conference and has arranged site visits to clinics for those delegates wanting to see how TB services are delivered in the clinics. On Tuesday, 6 November, an international press delegation will visit two clinics.

"This conference affords the City the opportunity to focus the international spotlight on and showcase the good work done by local staff," says Dr Ivan Toms, Executive Director: City Health.

"Last year, the City's Health Directorate reached its best TB cure rate ever for new smear positive TB cases (i.e. those cases which are infectious and spreading TB), at 76% cured, and 82% successful completion of treatment (probably cured but not proven by two negative sputa checks). Epidemiological modelling suggests that if 85% of new smear positive TB cases can be cured, then the epidemic will begin to decline as the infectious pool in the community shrinks"

Last year, Cape Town, as a health district, had the second highest caseload of TB in South Africa (Durban had more cases). The City reported 27,017 cases (26,860 in 2005). Reaching a 76% cure rate and 82% successful completion of treatment with these numbers is due to the dedication, hard work, commitment and passion of City Health's clinic staff, managers and of course the unstinting support of the TB NGOs - particularly the TB Care Association.

These results showed huge gains in cure rates in many of the eight health sub districts in the City. Khayelitsha, which has 21% of the caseload, showed a 17% improvement in cure rate from the previous year. Mitchells Plain showed a 7% improvement (to a cure rate for the sub district of 83%). Klipfontein sub district (Athlone, Guguletu and Nyanga areas) also did extremely well with an 8% improvement on the previous year to reach a cure rate of 81%. These results meant that the overall cure rate for the City jumped by 7% as these three sub districts are the high burden areas of the city.

These good TB results are supported by a successful HIV prevention and treatment programme run by the Provincial Health Department and City Health. At the end of September this year, 20,688 clients were on anti-retroviral treatment at primary care facilities in Cape Town (City and MDHS), 435 at Metro Institutions and 1,805 at tertiary level facilities (GSH, Tyg, RXH). This is important as an untreated HIV positive person has a 10% yearly chance of contracting TB. This compares with an HIV negative person having only a 10% lifetime risk of contracting TB. In effect this means an untreated HIV positive person has a 60 times greater chance of contracting TB! In Cape Town one out of every two TB patients is HIV positive.

Multi drug resistant TB cases in the city have remained fairly constant at 1% of new cases and 4% of re-treatment cases. From January - September 2007, 347 new MDR TB cases have been diagnosed and placed on MDR treatment. There have been 42 confirmed XDR cases, of which 27 have been hospitalised and 15 have died. Of these cases 30% are known HIV positive.

"City Health has adopted a policy of affirming and rewarding staff and NGO partners for good performance and annually host a special awards ceremony which coincides with World TB Day". Dr Toms said.

Overall these excellent results are due to the following factors:

• The dedication, hard work and passion of staff and TB NGOs
• Improved systems implemented and supported by local manager
• Strong monitoring and evaluation of the programme with feedback to all concerned
• Partnerships between City Health, Provincial Health Department and TB NGOs
• Additional funding by the Provincial Health Department to high-burden sub clinics
• Affirming staff and TB NGOs through awards and certificates

Issued by:
Communication
City of Cape Town
Tel: 021 400 2201

Media Queries:
Dr Ivan Toms
Executive Director: City Health
Tel: 021 400 2100
Cell: 084 220 0143