Case book tackles HIV and TB drug resistance

By Jonathan Davis, 15 April 2013 - Researchers from the Africa Centre for Health and Population Research near Mtubatuba have published a important book to help rural doctors, nurses and pharmacists working on the frontline of the country's interlinked HIV and tuberculosis (TB) pandemics manage increasing levels of resistance to the drugs needed to fight the diseases.

While the broad provision of antiretroviral (ARV) drugs to HIV sufferers has been shown to not only reduce mortality from the disease but also inhibit its spread, where patients fail to take their medication properly, drug-resistant strains of the virus take root. With millions of South Africans now expected to take complex ARV regimes for the rest of their lives, the threat of resistance is huge.

This is especially true for rural patients, where difficulties in reaching hospitals and clinics or even simply a lack of food make taking the drugs, which have unpleasant side effects, a challenge. Similarly, TB, which takes advantage of the weakened immune system of many HIV sufferers, can be treated but only through months of faithful adherance to treatment.

Rural health systems are already struggling to manage multiple-drug resistant (MDR) and extreme drug resistance (XRD) forms of the disease. The HIV & TB Drug Resistance & Clinical Management Case Book, edited by Africa Centre HIV and TB specialist Dr Richard Lessels and virologist and bioinformatician Tulio de Oliveira, together with University of Pretoria HIV expert Dr Theresa Roussouw, was published by the Medical Research Council last month.

The book is a compilation of informative clinic cases from across South Africa that illustrate the challenges health workers face in managing increasingly complex forms of resistance. The book was launched last month at a two-day workshop at the Ghost Mountain Inn near Mkhuze, attended by doctors and senior nursing and pharmacy staff from the five district hospitals in the uMkhanyakude District.

The meeting, sponsored by Africa Centre and the uMkhanyakude Health District, was also attended by HIV and TB specialists from the University of KZN, Durban's King Edward Hospital and from as far away as Botswana. Dr Hervey Vaughan-Williams, District Family Physician at the uMkhanyakude Health District Office said he was pleased with the number of district staff who attended the workshop.

'Gatherings such as these are valuable both for District staff education and bonding between institutions, which is invaluable in times of stress or crisis, as well as enriching the working environment,' he said. Two hundred and fifty copies of the book were donated by Africa Centre to staff of the five hospitals in the district.

However, in order to allow dissemination of the information, Dr Lessels said the book had been published under an 'open source' licence that allows it to be freely shared both in print copies and electronically. Publication was supported by the European Commission's Centre for Disease Control and UK charity Wellcome Trust. A similar launch event was also held in Pretoria to promote the case book among HIV and TB specialists there.

News date: 2013-04-15


Publication cited

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