Zimbabwe Could Face Increased Prevalence of Drug-Resistant TB, Officials Say

Conditions in Zimbabwe have hindered the ability of physicians to detect and treat tuberculosis, which could lead to a rise in unidentified cases of multi-drug and extensively drug-resistant TB, according to officials, Inter Press Service reports. According to Inter Press Service, Zimbabwe is facing a shortage of financial resources and health workers, and many hospitals and clinics have closed recently because of difficult conditions. The country also lacks sufficient supplies of TB drugs, which has led government hospitals to refer patients to rural clinics that receive support from international aid organizations.

Clemence Duri, head of two infectious disease hospitals in Zimbabwe's capital of Harare, said the number of MDR- and XDR-TB cases in Zimbabwe is unknown because of improper patient health record documentation. "The truth is that we don't know the extent of the MDR-TB, but it is likely that it is high, and it is also likely that we have many cases of XDR-TB," Duri said, adding, "Most of the TB patients we see at the hospital have been infected at least twice." Charles Sandy, Zimbabwe's national TB coordinator, at the recent National TB Capacity Building and Policy Dialogue Platform conference said that Zimbabwe could face a sudden increase in MDR-TB cases. According to Sandy, Zimbabwe has "cases of MDR- and XDR-TB for sure," but it is difficult to diagnose the disease because the country's only TB testing lab does not function because of outdated and broken equipment. Duri added that most health centers in the country are "poorly resourced" and unable to conduct studies because they have "no capacity, no computers or even test kits." According to Inter Press Service, TB treatment in Zimbabwe often relies on physicians' ability to recognize TB symptoms, and therefore many TB cases go undiagnosed or are not treated properly.

According to 2007 statistics from Zimbabwe's Ministry of Health and Child Welfare, the country's TB case detection rate is 42%, compared with the World Health Organization's target of 70% case detection. In addition, Zimbabwe has a treatment success rate of 68%, below the WHO target of 85%. Physicians in Zimbabwe have called for the health department to implement awareness and education programs to control the spread of the disease. TB control efforts should involve community members and take place at the local level, Duri said. According to Inter Press Service, Zimbabwe's health department asserts that international sanctions have prevented the country from receiving donor aid that could help improve its health services (Kwenda, Inter Press Service, 3/3).