The government of Botswana announced yesterday that two cases of extensively drug-resistant tuberculosis (XDR TB) have been identified in the country. They are the first cases to be reported in sub-Saharan Africa outside South Africa.
Two patients with XDR TB have been quarantined at the Princess Marina Hospital in Gabarone.
Extensively drug-resistant TB is a form of TB that is resistant to the first-line drugs isoniazid and rifampicin, the fluoroquinilone class of antibiotics, and at least one of the injectable antibiotics used in the treatment of multi-drug resistant TB.
XDR TB is very difficult to treat and may have a very rapid disease course in people with HIV. It can only be diagnosed by laboratories equipped to carry out drug susceptibility testing, with the result that outside South Africa, its prevalence in sub-Saharan Africa is unknown. Nearly 500 cases of XDR TB have been diagnosed in South Africa since 2006, when an outbreak was first identified in KwaZulu Natal province.
Over 100 people were recently diagnosed with multi-drug resistant TB (MDR-TB) in Botswana and are now being treated as outpatients, Dr Julius Mboya, head of disease control at Princess Marina Hospital told the Botswana Press Agency.
“We know where all [MDR TB] patients are and we are monitoring their progress, but since they have all been educated on the dynamics of their condition, we feel they are not that risky to the public,” said Dr Mboya.
The Botswana approach to MDR TB treatment contrasts with the approach in some South African provinces, where patients with MDR TB have been required to spend lengthy periods in specialist treatment facilities to receive supervised treatment.
The Permanent Secretary in the Ministry of Health, Ms Batatu Tafa yesterday released a press statement appealing to all people with chronic coughs and those who have been exposed to patients with active TB to visit the nearest health facilities for a check up.