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Nyemudzai Kakore Herald Reporter
The number of tuberculosis cases in Harare has almost halved, a development largely attributed to the growing intake of life-prolonging drugs and improved access to high quality first-line anti-TB drugs, according to the latest city health report. The Harare City Health annual report for 2012-2013 indicated that the cases had dropped substantially by 47 percent from 502 662 cases in 2012 to 240 124 in 2013.

City Health Department director Dr Prosper Chonzi told The Herald that the incidence and prevalence of TB had declined significantly in the past three years owing largely to improved Government interventions, improved access of anti-retroviral therapy to People Living

With HIV and Aids (PLWHAs) as well as successful HIV care and treatment programmes in the city.
“Intervention programmes introduced by Government and its partners such as circumcision, the use of condoms and early counselling and testing has helped in reducing the trend of the aforementioned diseases,” he said.

TB is the leading cause of death among PLWHA in the city and the decline was in tandem with a sharp fall in TB cases at both national and continental levels.

At least 78 percent of TB patients in the city were HIV positive. The city health report also showed that the poorest areas (western and southern suburbs) had the highest TB rates while rates for richer areas (northern suburbs) had much lower rates.

In 2010, Zimbabwe recorded 47 000 TB notifications and this fell down sharply to 41 000 in 2011. The notifications further went down to 38 367 in 2012 and were expected to decline further in figures for 2013.

The World Health Organisation says ART coverage increased siginficantly in Africa registering a 20 percent upsurge from 2009 to 2010 alone.

And this, the WHO says, has contributed largely to the aversion of AIDS-   related deaths.  UNAIDS estimates that access to treatment has prevented 2,5 million HIV-  related deaths between 1995 and 2010, mainly through crashing mother-to-child transmission rates.
Health experts believe that an integrated approach to HIV/AIDS, malaria and TB will have positive spillover effects on maternal and child mortality, educational performance and the overall socio-economic development of the continent.

Dr Chonzi also attributed the decline to early detection.
“Early detection and testing of HIV over the years means patients are put earlier on treatment and opportunistic infections such as TB won’t come,” he said.

City TB cases recorded in 2013 show that males were more vulnerable compared to women. Of the 240 124 cases recorded, 133 184 were male while 106 940 were female.

In the previous year, 267 724 males received treatment while 117 166 were females. TB admission and death trends also revealed that in 2011 they were 379 admissions as compared to 165 in 2012.

A total of 116 deaths were recorded in 2011 with 32 in 2012.  TB affects mostly the productive age group of 25 to 44 years (the same that is affected by HIV).

There were fewer cases in 2012 compared to 2011 in most age groups.  Dr Chonzi said Pulmonary Tuberculosis (PTB) was the most common of all forms of TB recorded around the city.

Health experts recently revealed that cancers related to HIV are also on the decrease. They said most common cancers among black men indicate that Kaposi sarcoma incidence are at 20,3 percent and declining in a trend that oncologists say could be largely due to the introduction of life-prolonging drugs — ARVs — which have slowed down HIV and Aids deaths.

According to the WHO TB report for 2013, the estimated prevalence of all forms of TB in Zimbabwe in 2011 was 433 cases for every 100 000 people.

In 2004, the estimated prevalence was 807 for every 100 000 people. The WHO says TB prevalence rates were falling in all sub-regions.
However, health experts say more still needs to be done as TB infection rates depend not only on HIV status but also on institutional and socio-economic factors such as crowded living and working conditions and poor sanitation.