Zimbabwe Could Face Rising MDR-TB Prevalence, Officials Say

Conditions in Zimbabwe indicate that cases of multi-drug resistant tuberculosis could be increasing; however, the country's public health system does not have sufficient capacity to identify and treat such cases, some physicians said recently at the National TB Capacity Building and Policy Dialogue Platform meeting in the capital of Harare, the Zimbabwe Standard reports.

Charles Sandy, national TB coordinator, said that many people in the country could have MDR-TB but that Zimbabwe has not identified such cases because the country's national TB reference library does not have this capacity. According to Sandy, the country's TB case detection rate was 42% in 2007, compared with the World Health Organization's target of 70%. In addition, Zimbabwe has a treatment success rate of 68%, less than the WHO target of 85%. According to meeting participants, these statistics indicate that MDR-TB could be a major problem in Zimbabwe. However, the only data available on MDR-TB in the country, taken from a 1995 survey, indicate that 1.9% of TB cases involved drug-resistant strains, the Standard reports. Sandy said this is a "big problem" because Zimbabwe should have much fewer MDR-TB cases than the number reported in 1995.

According to the Standard, there is a "good chance" that drug-resistant TB is spreading in Zimbabwe, where more than five million people face food shortages, high inflation rates, and inadequate water and sanitation systems. In addition, inadequate health systems, insufficient diagnostic and laboratory capabilities, limited funding, migration and poverty could contribute to the emergence of drug-resistant strains, the Standard reports. According to Sipho Mahlangu, representative from the Zimbabwe National Network of People Living with HIV, many Zimbabweans opt out of HIV and TB treatment regimens because they cannot afford to buy food and cannot take the drugs on an empty stomach. In addition, a shortage of medical workers has led many health centers to stop following up with TB patients to ensure that they adhere to treatment regimens (Zimbabwe Standard, 1/31).