FORCIBLY detaining people infected with a deadly strain of drug-resistant tuberculosis may be the only way to stop its spread. So say AIDS specialists in South Africa, where cases of extensively drug-resistant TB (XDR-TB) are spiralling out of control.
In KwaZulu-Natal, the province hardest hit by South Africa鈥檚 HIV epidemic, 30 new cases of XDR-TB are being reported each month. HIV makes people easy prey to the disease, which is resistant to most anti-TB drugs and kills almost everyone it infects within 16 days.
鈥淚f XDR-TB is not contained, completely drug-resistant TB is waiting in the wings to take its place,鈥� says Jerome Singh at the Centre for AIDS Programme of Research in South Africa, based in Durban, KwaZulu-Natal, who is calling for the government to take firmer action (PLoS Medicine, DOI: 10.1371/journal.pmed.0040050).
Advertisement
Cases of XDR-TB have been reported all over the country but there are currently no infection control centres, except at King George V Hospital in Durban, which is treating just 11 patients.
鈥淚n New York state, forcible confinement and treatment of TB cut infection rates鈥�
Singh wants South Africa to follow the example of New York state in the 1990s, where forcible confinement and treatment of people with TB cut infection rates. To sweeten the pill, the South African government needs to provide welfare benefits to XDR-TB patients while they are in hospital, so they don鈥檛 lose out on wages, Singh says. Such measures 鈥渃an help contain the spread although they won鈥檛 stop it completely鈥�, he warns.
