On PBS’ NewsHour, Dr. Refiloe Matji Addresses How Conditions
in South Africa are Conducive to Spread of Tuberculosis
The NewsHour with Jim Lehrer episode which aired on the Public
Broadcast System on March 24, 2009, World TB Day, featured an interview with
Dr. Refiloe Matji, URC’s Southern Africa Regional Director.
“The major problem in TB is compliance,” Dr. Matji points out.
"If the patient does not adhere to the complete six months of treatment necessary
to cure TB, deadly drug resistant strains of TB can develop."
“Are we saying people who have TB are different than us? They are not,”
she says. "Unfortunately, the circumstances in which they live may result in not
complying with the full course of treatment."
TB diagnostic procedures were developed over 100 years ago; new
testing procedures are in use but not widely available. Often, a clinic must
send the sputum to a facility in the city for testing.
Dr. Matji describes the circumstances and challenges facing patients
in rural areas who attempt to go to a clinic for testing and treatment: “A patient
will walk the distance to the clinic. He is ill. What is the patient told?
‘Take these three bottles [for sputum collection] go back home’…You are ill.
You are in pain…patients end up not coming back and dying.”
Living conditions in South Africa may be conducive to spread of
the disease. In South Africa, it can get very cold in the winter, she explains.
Therefore, homes, with little heat, often do not have windows to provide the sunlight
and circulation so important to controlling spread of the bacteria. In these
homes, TB can be transmitted very easily.
However, Dr. Matji points out, when a patient begins treatment,
infectiousness is reduced. Therefore, she emphasizes, it is critical that
other members of the household undergo testing.
International commitment is essential to successfully treating
and controlling TB, Dr. Matji says. She speaks of a need to develop new
drugs that require a shorter term of treatment:
“It takes six months to cure a patient, which is a long time.
Imagine if we were told there was a drug that would cure TB in 5 days…”
Listen to the March 24, 2009 feature on the spread of TB in South
Africa. For the interview with Dr. Matji,
click here.
Dr. Refiloe Matji is an authority on TB surveillance, care,
and control and has been a leader in raising awareness of TB/HIV co-infection,
both in South Africa and internationally. As URC’s Regional Director for
Southern Africa, she oversees the USAID Health Care Improvement Project
activities in South Africa, Lesotho and Swaziland, the TASC2 TB Project in
South Africa, CDC-funded activities on HIV counseling and testing in South
Africa, Lesotho and Swaziland, and the Injection Safety Project in Namibia.
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