Resurgence of TB causes concern

Malnutrition due to the ongoing food crisis, the HIV/AIDS epidemic, and overcrowded urban areas are all contributing to a rise in tuberculosis (TB) infections in Zimbabwe. Nicholas Siziba, the national coordinator of the Ministry of Health's special TB programme, sounded the alarm last week while visiting Matabeleland South province - one of the worst-affected in terms of TB rates. He said the annual number of infections for the southern province had risen to 3,000, up from slightly over 2,000 in previous years. "In Matabeleland South, TB remains a major public health problem. This is largely because of a high prevalence of HIV/AIDS infection rates in the community. The resultant malnutrition, poor sanitation and overcrowding in the urban areas contributes to the easy spread of the disease." Siziba said the rapid increase in infections across the country called for the participation of the private sector and NGOs in fighting the resurgence of the illness. "This is not a problem that can be left to the Ministry of Health and Child Welfare alone, because more people are dying of TB than other curable infectious diseases," he stressed. The Zimbabwe Association for the Rehabilitation and Prevention of Tuberculosis (RAPT) warned that TB was emerging as the major opportunistic killer of people living with AIDS. RAPT national co-ordinator Ellen Ndimande told IRIN that TB, riding on the back of the HIV/AIDS epidemic, was fast getting out of control. "Since 1954 we have had a very successful fight against the disease, to the point where the association declared that the war on TB had been won. But the past few years have shown us that the disease has re-emerged to become the number one killer of people with HIV/AIDS," said Ndimande. "The high prevalence of HIV/AIDS in this country has facilitated the resurgence of the disease, at a time when government and private organisations are over-stretched in financial and human resources," she added. RAPT was hamstrung in responding by a serious cash crisis. "We have suspended at least three awareness and mitigation programmes due to have been done this year. RAPT now depends only on its fundraising activities. The business sector, which previously supported us generously, is no longer in a position to donate because they also face varying financial problems due to the state of the economy," Ndimande explained. She said RAPT was wrapping up its last programme of TB awareness among food vendors in Bulawayo. Ndimande called on the government to come up with a revised programme aimed at fighting both TB and HIV/AIDS. "These diseases have become partners, and we cannot fight one in isolation from the other. Although most HIV/AIDS patients are tested for TB, the separation of treatment programmes works against the goals of defeating both," Ndimande said. Efforts to get a comment from Stanley Midzi, the director of disease control and prevention in the ministry of health, were unsuccessful. Zimbabwe, which received a UN World Health Organisation grant to fight TB and malaria earlier this year, is rated among 22 countries with the heaviest TB burden worldwide.