Deadly TB Strain Triggers Debate Over Forced Quarantine

By Stephen Mbogo | July 7, 2008 | 8:17 PM EDT


Nairobi, Kenya (CNSNews.com) - A deadly new strain of multi-drug resistant tuberculosis that is especially infectious to people who are HIV-positive, is threatening to overwhelm Africa's health systems and its spread, according to health practitioners here.

The strain, known as XDR-TB (extreme drug resistant tuberculosis), has already caused panic in South Africa where the government says it has caused the deaths of 74 people.

Research specialists say the most effective way to halt the spread is to isolate those infected, forcibly if necessary, until they die - advice that has sparked a debate, given the South African constitution's guarantees on individual rights.

The World Health Organization (WHO) says there is a correlation between TB and HIV infections.

Sub-Saharan Africa is home to 25.8 million HIV-positive people - two million people in the region died of AIDS last year - and because of the prevalence of the infection, health professionals are worried the virulent TB strain could also spread quickly.

Kenyan microbiologist Dr. Desmond Owino said that if the disease goes unchecked, the worst case scenario is massive deaths. Because treatment was expensive, a spread would also put a strain on national health budgets.

"We should move very fast to see how its spread can be arrested," he said.

In South Africa, some doctors are urging enforced quarantine, arguing that while unpleasant, detaining infected people until they die is preferable to allowing them to infect others in the wider community.

Owino said he encouraged a debate over whether those infected should be isolated. Any such isolation should not affect the dignity of the patient.

Davis Malombe of the Kenya Human Rights Commission said although discrimination is not permissible under any circumstances, isolating patients was acceptable if done in the correct way.

"The problem is how that isolation is done," he told Cybercast News Service. "The isolated patient continues to have a right to health and access to treatment. If this is followed, then I do not see any problem with isolation."

The South African government's health department is considering the isolation recommendations.

According to Stanley Njoroge of the Centrale Humanitaire M?dico-Pharmaceutique (CHMP), a public health humanitarian group, cases have been reported in Kenya, Uganda and Tanzania of TB infections that could not be cured with conventional medical treatment.

Njoroge said although cases of the XDR-TB strain were not widespread, it was important that the world take note and arrest its spread before it is too late.

"This strain is very expensive to treat and this means less people will have access to the available medicines," he said. "What we are likely to see is lots of deaths."

The WHO says it is facilitating investigation of the magnitude of XDR-TB globally, particularly in southern African countries.

The agency says on its website that while drug-resistant TB may be treatable, it requires up to two years of treatment that is more than 100 times more expensive than treatment for regular TB.

Scientists suspect that the XDR-TB strain may have developed because patients with regular TB - itself a major killer in Africa - had skipped some of their treatments, or had been under-medicated.

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