AP News, January 16th, 2008
Health authorities on Wednesday reported the first known cases of virtually untreatable tuberculosis in Botswana, following fears that the highly contagious strain has spread beyond neighboring South Africa.
The health ministry said there were two cases of so-called extremely drug resistant tuberculosis, or XDR-TB, as well as 100 cases of the slightly more manageable multi-drug resistant TB, or MDR-TB.
Although XDR-TB has been reported in other parts of the world, especially former Soviet republics, it is particularly lethal in southern Africa, where AIDS incidence is high, because it combines with AIDS to kill.
The drug resistant forms of TB have developed largely because patients don't stick to their six-month course of treatment.
For the past few months, health professionals have warned that XDR-TB, although only confirmed in South Africa, had spread to other southern African nations like Swaziland and Lesotho hard hit by the AIDS epidemic, but hadn't been diagnosed because of lack of laboratory facilities.
Nearly 400 cases have been reported so far in South Africa, but there may be more cases. Testing methods are inaccurate and out of date and many patients die before they are diagnosed. Botswana is the only other country in southern Africa with testing facilities.
Several provinces in South Africa have taken legal action to force drug resistant TB patients to stay in hospitals in isolation units surrounded by wire fences and protected by guards.
Although forced confinement of patients violates most medical ethics, authorities say they have no choice but to put the wider public good above individual rights. Confinement for XDR-TB is at least six months, usually much longer.
Dozens of patients with the disease escaped from two hospitals in South Africa's Eastern Cape province just before Christmas, saying they wanted to spend the festive season with their families. South African police mounted door-to-door searches for the patients. Eight still reportedly remain at large.
___
Associated Press Writer Clare Nullis contributed to this report from Cape Town, South Africa.
