South Africa: Many patients discharged without a cure

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Tuberculosis: Many sick people are released in South Africa

In South Africa, patients with tuberculosis that is resistant to antibiotics are regularly discharged from the clinic because they do not have enough beds. This poses a great danger to the people around them.

Deadly threat to the environment of the sick Although they are not cured, patients with antibiotic-resistant tuberculosis are regularly discharged from the clinic in South Africa. For the people in the vicinity of the sick, this represents a deadly danger, according to a study published in the specialist magazine "The Lancet". Study leader Keertan Dheda from the University of Cape Town said: "Nationwide there are systematic unsuccessful treatments and patient discharge" from the hospital. For several years, the professor of pulmonary medicine and his team followed the fate of 107 patients from three South African provinces who were treated for so-called XDR tuberculosis.

Three-fourths of the patients who died after four years XDR stands for Extensively Drug-Resistant and means that the pathogens are resistant to all first-line tuberculostatic agents and to at least two second-line tuberculostatic agents. 44 of the observed patients were also infected with HIV. Four years after the start of the study, 79 patients had died, which corresponds to 74 percent. 45 patients were discharged from the clinic during the investigation period. The treatment had not worked for around 50 percent of them, so they left the clinic seriously ill. On average, they died 20 months after their release and during this time they were extremely dangerous for their environment.

Urgent need for more accommodation Using a DNA analysis of a tuberculosis pathogen, the researchers were able to prove that one of the patients infected his brother, who later died of the lung disease. "Many patients who did not respond to the treatment are discharged simply because there are only a few beds in tuberculosis hospitals and there is a lack of alternative long-term accommodation or places of death," said Dheda. In order to tackle the problem, more accommodations urgently need to be created and treatment options at home improved.

Highest infection rates in southern Africa The South African study draws attention to the dangers posed by multi-resistant pathogens. Among other things, these could arise due to the incorrect use of antibiotics. According to the World Health Organization (WHO), tuberculosis is on the decline worldwide, but it still tops the global statistics on fatal infectious diseases. According to their information, over 1.4 million people died of it in 2012. Last year, the WHO warned that there had been too little progress in controlling resistant tuberculosis. The two countries South Africa and Swaziland have the highest infection rates worldwide. The spread there is particularly favored by insufficient hygienic conditions and very populated areas. South Africa is also particularly affected by the resistant pathogens.

Minor problem in Germany Tuberculosis is still relatively widespread, especially in Asia, Africa and the Eastern European countries. In Germany, the problem is relatively minor, but according to the Robert Koch Institute, the infection rate is also increasing among children in Germany. Most often, the disease, also known as consumption or “the moths”, appears as an infection of the lungs, with persistent coughing, chronic fatigue, weight loss, fever with night sweats and a stinging in the chest, which can be signs of tuberculosis. Anyone who experiences such symptoms should urgently consult a doctor, since untreated tuberculosis results in the death of those affected in around 50 percent of cases. (ad)

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