Published Date: 2008-04-03 15:00:19
Subject: PRO/EDR> Tuberculosis, XDR - Namibia
Archive Number: 20080403.1231
TUBERCULOSIS, XDR - NAMIBIA
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 2 Apr 2008
Source: AllAfrica, The Namibian (Windhoek) report [edited]
Health professionals are quietly treating up to 24 confirmed cases of
extensively drug-resistant tuberculosis (XDR-TB), the worst form of TB with
seriously limited treatment options and chances of cure, in Namibian hospitals.
Well-placed health sources have confirmed to The Namibian that the extreme
form of TB is currently under control, but expressed fears that the country
does not have the capacity to deal with a major outbreak of XDR-TB.
The Namibian had been aware of at least one case being treated at Walvis
Bay since December 2007, but health sources said this week that the
situation was worse than initially thought.
On Friday [28 Mar 2008], health minister Dr Richard Kamwi only expressed
fears that Namibia was about to record its 1st cases of XDR-TB. "There are
currently 254 cases of multi-drug-resistant TB [resistant to the 2 best
1st-line anti-TB drugs INH (isoniacid) and rifampin - Mod.LL] under
treatment throughout the country. This is a great concern and is a clear
indication that it is only a matter of time before we will have extremely
drug-resistant cases, known as XDR tuberculosis, in Namibia [MDR-TB with
additional resistance to the oral fluoroquinolones, and at least one of the
3 injectable anti-tuberculosis drugs capreomycin, kanamycin, and amikacin -
Mod.LL])," Kamwi said at the World TB Day event staged at Mariental on
Friday [28 Mar 2008].
He said experts in the Ministry of Health were busy reviewing all TB cases
with drug resistance to verify the extent of the problem. "Given the large
number of cases, we may well find some XDR-TB amongst this group," Kamwi said.
Kamwi confirmed that Namibia was the country with the 2nd highest TB
incidence in the world after Swaziland, with 15 244 cases reported in 2007
The host region of this year's TB Day event, Hardap, had the highest
incidence of TB in Namibia in 2007, reporting a worrying 1294 cases per 100
000 people, Kamwi said.
The TB situation is exacerbated by the HIV-AIDS epidemic in the country.
"In 2007, 8186 TB patients representing 54 per cent of the total notified
patients were tested for HIV and 59 per cent were HIV positive," Kamwi
said. He said the impact of the dual infection of TB with HIV-AIDS was a
major cause for concern, in particular as it affected the Namibian workforce.
[byline: Christof Maletsky]
[Namibia shares a border with South Africa the country where the XDR-TB was
initially discovered linked primarily to HIV co-infected individuals. The
border can be found on a map at <http://en.wikipedia.org/wiki/Namibia>.
It is not clear from the posting if the presumed XDR-TB strain(s) are
identical to those from South Africa or other countries with the isolates.