Health care workers at higher risk of drug-resistant TB

Health care workers in South Africa's KwaZulu-Natal (KZN) Province, on the east coast, are at much higher risk of drug-resistant tuberculosis (TB) than the general public, according to new research.



A study of 3,639 patients referred to King George V Hospital, the province's specialist treatment centre for drug-resistant TB, between 2003 and 2007, found that 235 were health care workers. Of these, 23 had extensively drug-resistant (XDR) TB, which is resistant to most TB medicines.



The researchers calculated that the incidence of XDR-TB and multidrug-resistant (MDR) TB, which is resistant to the two most powerful anti-TB drugs, is six to seven times higher among health care workers than among non-health care worker patients.



The findings confirm what experts have long suspected - that poor TB infection control measures in many of South Africa's health facilities are putting health care workers at risk.



"The message is simple," one of the study's authors, Prof Keertan Dheda of the University of Cape Town, told IRIN/PlusNews. "We need to take infection control seriously."



Activists attending a national AIDS conference in Durban, KZN, in April called for the implementation of basic infection control measures, including an adequate supply of masks to health care workers and patients, to slow the spread of drug-resistant TB in the country.



South Africa has one of the highest burdens of MDR-TB in the world, with about 10,700 new cases reported a year, according to the World Health Organization.



People living with HIV are particularly susceptible to TB infection, but many of the health care workers treated for drug-resistant TB at George V Hospital were HIV negative. The researchers recommended that any health care worker suspected of having TB be screened for drug resistance, regardless of their HIV status.



"We need national guidelines on how they should be screened and managed for TB, and we don't have that at the moment," said Dheda. "What we always suspected is real, and it underscores the need to intensify current efforts."



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See also: SOUTH AFRICA: Saving lives is not always easy