Cape Town - Community health-care workers will move from Covid-19 contact tracing to now actively searching for people with Tuberculosis (TB) who have abandoned their treatment plan.
Two non-profit organisations – In the Public Interest (IPI) and Philani – contracted by the provincial Health and Wellness Department – have been tasked with contact tracing of TB patients who are no longer maintaining their TB treatment or attending health-care facilities for their monthly check-ups.
The organisations operate in the Klipfontein and Mitchells Plain area as part of the department’s Community Oriented Primary Care (COPC) initiative.
Department spokesperson Monique Johnstone said hot spots in the Klipfontein and Mitchells Plain substructures were Crossroads, Philippi and Tafelsig, with contributive factors including dual diagnosis with HIV, substance abuse, and impoverished living conditions and crowded living areas.
“People generally struggle with healing because of food insecurity, poor living conditions and dual diagnosis, which impact immunity, and substance abuse which impacts medication compliance. Side-effects of some of the medication can also be a deterrent for patients,” she said.
The de-escalation of services due to the Covid-19 pandemic could have led to the higher rates and spread of TB, as people were fearful of attending health facilities to avoid contracting Covid-19. Many patients also left the province to spend lockdown in other areas and could not access their medication, Johnstone said.
Public Interest HIV/Aids and TB supervisor Portia January said: “We track the patient by finding them by their nicknames. Some people are on drugs, and we trace them to the drug den.
“We also have people who are in gangs and leave their original homes to hide, which makes it difficult to find them. We go out of our way to find the patient and because of our relationship with the community, we leave messages, and sometimes the patient does come to the clinic to be placed back on treatment.”
Philani staff nurse Phelisa Bajisi said the challenge with tracing patients was that people gave the wrong addresses at clinics, or had moved and did not update their contact information.
“We trace people living with TB from children under 5 to adults. We trace 10–15 people daily who are not maintaining their treatment.”