{"page":"\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/resources-572d6a42.css\" /\u003e\n\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/lp_boclips_stylesheets-f4d0de30.css\" media=\"all\" /\u003e\n\u003cdiv data-title='South Africa trials new apporoach to TB treatment' data-url='/boclips/videos/5c54bb7ed8eafeecae1257c0' data-video-url='/boclips/videos/5c54bb7ed8eafeecae1257c0' id='bo_player_modal'\u003e\n\u003cdiv class='boclips-resource-page modal-dialog panel-container'\u003e\n\u003cdiv class='react-notifications-root'\u003e\u003c/div\u003e\n\u003cdiv class='rp-header'\u003e\n\u003cdiv class='rp-type'\u003e\n\u003ci aria-hidden='true' class='fai fa-regular fa-circle-play'\u003e\u003c/i\u003e\nVideo\n\u003c/div\u003e\n\u003ch1 class='rp-title' id='video-title'\u003e\nSouth Africa trials new apporoach to TB treatment\n\u003c/h1\u003e\n\u003cdiv class='rp-actions'\u003e\n\u003cdiv class='mr-1'\u003e\n\u003ca class=\"btn btn-success\" data-posthog-event=\"Signup: LP Signup Activity\" data-posthog-location=\"body_link_boclips\" data-remote=\"true\" href=\"/subscription/new\"\u003e\u003cspan\u003e\u003cspan\u003eGet Free Access\u003c/span\u003e\u003cspan class=\"\"\u003e for 10 Days\u003c/span\u003e\u003cspan\u003e!\u003c/span\u003e\u003c/span\u003e\u003c/a\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-body'\u003e\n\u003cdiv class='rp-info'\u003e\n\u003cdiv aria-label='Hide resource details' class='rp-hide-info' role='button' tabindex='0'\u003e\u0026times;\u003c/div\u003e\n\u003ci aria-label='Expand resource details' class='rp-expand-info fai fa-solid fa-up-right-and-down-left-from-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003ci aria-label='Compress resource details' class='rp-compress-info fai fa-solid fa-down-left-and-up-right-to-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003cdiv class='rp-rating'\u003e\n\u003cspan class='resource-pool'\u003e\n\u003cspan class='pool-label'\u003ePublisher:\u003c/span\u003e\n\u003cspan class='pool-name'\u003e\n\u003cspan class='text'\u003e\u003ca data-publisher-id=\"30356011\" href=\"/search?publisher_ids%5B%5D=30356011\"\u003eCurated Video\u003c/a\u003e\u003c/span\u003e\n\u003c/span\u003e\n\u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-description'\u003e\n\u003cspan class='short-description'\u003eAP Television Khayelitsha, Cape Town, 2nd October 20081. Wide of Khayelitsha street 2. Medium of Khayelitsha street 3. Medium of Ubuntu Clinic waiting room 4. Ubuntu Clinic patient with mask on5. Set up Nondumiso Zulu, patient with MSF...\u003c/span\u003e\n\u003cspan class='full-description hide'\u003eAP Television \u003cbr/\u003eKhayelitsha, Cape Town, 2nd October 2008\u003cbr/\u003e1. Wide of Khayelitsha street \u003cbr/\u003e2. Medium of Khayelitsha street \u003cbr/\u003e3. Medium of Ubuntu Clinic waiting room \u003cbr/\u003e4. Ubuntu Clinic patient with mask on\u003cbr/\u003e5. Set up Nondumiso Zulu, patient with MSF pilot MDR treatment programme\u003cbr/\u003e6. SOUNDBITE: (English) Nondumiso Zulu, patient with MSF pilot MDR treatment programme: \u003cbr/\u003e\"I was diagnosed with MDR TB on 21st November 2007.  At that time I was very very sick, in so much that I couldn't walk on my own.\"\u003cbr/\u003e7. Various Khayelitsha \u003cbr/\u003e8. Wide University of Stellenbosch, Tygerberg\u003cbr/\u003e9. Centre for Excellence, Miomedical TB Research plaques \u003cbr/\u003e10. Laboratory wide - professor and assistant\u003cbr/\u003e11. SOUNDBITE: (English) Rob Warren, Prof. and Researcher at the University of Stellenbosch: \u003cbr/\u003e\"TB is a bacteria that is breathed in by a human host, it has a very specialised cell wall, that, when it's taken up by the macrophages, which are the normal cells that are involved in killing bacteria, in our lungs or in our body; they are taken up by these cells, they are actually able to hijack the body in some way, which allows them to reside within that macrophage.\"\u003cbr/\u003e12. Medium of lab technician harvesting MDR cultures\u003cbr/\u003e13. Close scraping MDR culture\u003cbr/\u003e14. SOUNDBITE (English) Prof. Rob Warren:\u003cbr/\u003e\"MDR is a definition that is given to Microbacterium Tuberculosis when it becomes resistant to the two most important first line drugs.\"\u003cbr/\u003e15. Medium TB Medications and files at clinic\u003cbr/\u003e16. Close TB medications\u003cbr/\u003e17. TB Patients waiting at clinic\u003cbr/\u003e18. Close TB Infection Control poster \u003cbr/\u003e19. SOUNDBITE: (English) Virginia Azevedo, Head of Decentralisation Programme for the City Department of Health:\u003cbr/\u003e\"The National Policy, is that patients must all be admitted, and they must remain in hospital for the intensive phase, or until the sputum culture turns out negative.  But then, that's the policy.  In reality, you often don't have enough beds to admit all the patients that you require to admit.\"\u003cbr/\u003e20.  Wide Ubuntu clinic counselling group (led by Busiswe Beko)\u003cbr/\u003e21.  Medium Ubuntu clinic counselling group\u003cbr/\u003e22.  Close newspaper article of Busiswe \u003cbr/\u003e23.  SOUNDBITE: (English) Busiswe Beko, counsellor for the decentralisation programme and ex-MDR patient since May '08:\u003cbr/\u003e\"For us here in Khayelitsha, the hospital is far away.  And others you will find that they struggle to go and visit their patient in BCH (Brooklyn Chest Hospital), and if you usually go to BCH, we usually go on Fridays to visit the patients in BCH, what you will find there, the patient is there maybe 2, 3 months, no one has visited, and then he is getting depressed, and then somehow, when, if he or she gets a pass out for a weekend to come and see their family, and then it's difficult for him to go back to the hospital.\"\u003cbr/\u003e23. Medium MSF office front\u003cbr/\u003e25. Medium \"Stop TB, open a window!\"  emblem on jacket\u003cbr/\u003e26. Close TB Time for Change poster\u003cbr/\u003e27. Medium Khayelitsha Site B exterior sign \u003cbr/\u003e28. Wide Ubuntu Clinic entrance\u003cbr/\u003e29. SOUNDBITE: (English) Cheryl McDermid, Medical Doctor with the MSF/City Health Decentralisation Programme:  \u003cbr/\u003e\"Providing infection control both in the clinic, the community and the patient's home. We're also providing adherence counselling on a regular basis, and providing training to all the staff on the diagnosis and management of drug-resistant TB, as well as dealing with the side effects of these drugs.\"\u003cbr/\u003e30. Medium Khayelitsha Town 2 clinic interior \u003cbr/\u003e31. Close Ubuntu Clinic pharmacy window\u003cbr/\u003e32. Close \"Stop TB - open the window!\" sticker on clinic window \u003cbr/\u003e33. Medium TB and HIV poster \u003cbr/\u003e34. Medium clinic patients holding masks\u003cbr/\u003e35. Medium Ubuntu Clinic entrance sign in Xhosa\u003cbr/\u003eSouth Africa is 4th on the World Health Organisation's list of 22 high burden countries responsible for 80% of the world's TB. \u003cbr/\u003e14,000 of the nation's current TB infected are in the Multi Drug Resistant (MDR) category, meaning they do not respond to most of the front-line drugs currently being used to treat this airborne bacterial disease. \u003cbr/\u003eIn Khayelitsha, Cape Town's largest shantytown, more than 6000 patients have been diagnosed with TB. \u003cbr/\u003eMore than 500,000 cases of the highly contagious disease,  are expected in the country by the end of this year. \u003cbr/\u003eMany are too sick to seek help at the Government's designated treatment centres.\u003cbr/\u003eResearcher at the University of Stellenbosch, Professor Rob Warren, explains that TB is an airborne disease that once inhaled by humans hijacks cells in the body. \u003cbr/\u003ePatients diagnosed with MDR (or XDR - Extreme Drug Resistance) are seen as a threat to public health. \u003cbr/\u003eThey are referred to regional hospitals that give specialised treatment and are quarantined until they are cured.\u003cbr/\u003eThis can take up to two years in some cases, depending on how quickly they react to medication.\u003cbr/\u003eWhile treatment for all forms of TB is paid for by the state in an effort to make it accessible, the current national policy authorises the state to isolate MDR and XDR patients, against their will if necessary. \u003cbr/\u003eThere were 2,901 cases of multidrug-resistant TB in South Africa last year, and 561 cases of extensively drug-resistant TB. \u003cbr/\u003eBut the reported figures are believed to be only an indication of the real situation, because many patients die before they can be diagnosed. \u003cbr/\u003eThis year, the government is spending an additional 400 million rands ($50US million �32 million) on beds for people with drug-resistant TB. \u003cbr/\u003eBut anger and frustration are high at hospitals and there are constant staff shortages because nurses are afraid of contracting the disease. \u003cbr/\u003eHead of Decentralisation Programme for the City Department of Health, Virginia Azevedo says there is a lack of beds in public facilities which cannot keep up with the rapid rate of infection and the 4-24 month mandatory treatment time. \u003cbr/\u003ePatients are often depressed, a side effect of the disease, which is compounded by the isolation from their families who find it costly and difficult to travel the far distances to the MDR treatment hospitals. \u003cbr/\u003eBusiswe Beko is a former MDR patient turned counsellor for the decentralisation programme. \u003cbr/\u003eShe says that many patients become depressed because they go without visitors for months.\u003cbr/\u003eSome have been known not to return to the treatment centre after being given weekend passes as a result. \u003cbr/\u003eAs consequence, MDR, highly contagious as are all forms of tuberculosis, is spreading with little control or awareness.\u003cbr/\u003eCramped living quarters and basic facilities such as public transportation make this airborne disease highly infectious for a population with high levels of poverty, substance abuse, and HIV infection.\u003cbr/\u003eAn estimated 5.4 million of South Africa's 48 million people are HIV positive - that's 2/3rds of the world's HIV population. \u003cbr/\u003eAccording to Medecins Sans Frontiers (MSF) in Khayelitsha, 70% of TB patients are HIV infected, and TB is the most common cause of death.\u003cbr/\u003eNow MSF and the Cape Town City Department of Health are piloting a project which began in December 2007. \u003cbr/\u003eIt aims to create a model of decentralised care, with patients accessing local clinics for their daily medication. \u003cbr/\u003ePatient and family counselling, local intensive medical treatment and infection control are the main veins of approach for the pilot. \u003cbr/\u003eInitial studies for the scheme looked at the needs of the patient both for TB treatment as well as the social needs of the individual. \u003cbr/\u003eIt found that keeping the patient in their home environment could prove to be a more effective approach. \u003cbr/\u003eMDR patients begin treatment at their local clinic with medication, but are also supported by highly informed and trained counsellors, and are often paired up with another patient moving towards the end of their treatment, as a guide and support for newly diagnosed patients.\u003cbr/\u003eThe pilot programme works in close collaboration with the University of Stellenbosch's Centre for Molecular and Biomedical Research to test patients for sensitivity to a plethora of front line drugs. \u003cbr/\u003eSlow testing for MDR, mostly done through trial and error of drug sensitivity can leave the patient both untreated and infectious for 40 to 140 days. \u003cbr/\u003eFaster testing methods exist on the commercial market, but are expensive and therefore not feasible for the budget of the MSF/City Health project.\u003cbr/\u003eWhile it is too early to determine statistics for the success of the project - monitoring can take up to 5 years - the general sense of patients and counsellors is that this decentralised model is much more user friendly, encouraging patients to seek treatment and support, instead of running from states hospitals like prisons. \u003cbr/\u003eIf successful, the MSF/City Health model could be replicated in other areas of South Africa.\u003cbr/\u003e\u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv class='action-container flex justify-between'\u003e\n\u003cbutton aria-expanded='false' aria-label='Read more description' class='rp-full-description' type='button'\u003e\n\u003ci class='fai fa-solid fa-align-left'\u003e\u003c/i\u003e\n\u003cspan id='read_more'\u003eRead More\u003c/span\u003e\n\u003c/button\u003e\n\u003cdiv class='rp-report'\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv 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