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Rumbidzayi Zinyuke Senior Health Reporter

The treatment of tuberculosis in Zimbabwe has undergone a tremendous transformation over the years contributing to better outcomes for the national TB control programme.

TB remains one of the top killer diseases in Zimbabwe with an estimated incidence of 193/100 000 in 2020.

Although Zimbabwe has registered significant gains in the fight against the disease, treatment coverage stood at 55 percent in 2020, down from 72 percent in 2019.

The country’s TB/HIV co-infection rate is also high at 54 percent and Zimbabwe also remains among the top 30 countries with a high burden of multi-drug resistant TB.

Speaking on the sidelines of a media orientation on TB held recently, the Union Zimbabwe Trust TB and HIV officer Dr Tawanda Mapuranga the treatment regimens for the disease had evolved over the years.

“Over the years, the treatment of TB has seen a lot of improvements. For the drug susceptible TB this is the ordinary TB, we have seen an improvement especially in the introduction of the fixed dose combinations.

“Previously people used to take individual medicines in their good numbers so that in the end, collectively one would be taking a lot of tablets at a given time. But we then had a combined scenario whereby all the four drugs are now combined in one tablet and this then reduced the pill burden,” he said.

He said the country had also introduced child-friendly formulations, which were flavoured to make them palatable for young children.

Dr Mapuranga said some changes had also been made in the treatment of the Drug Resistant TB where in the past, people would take tablets for up to two years and daily injections for about six months.

“This came to about 180 doses of injectable drugs for the treatment of DRTB, but over the recent years, we have seen changes in the duration of treatment. The injectables have also been removed and we are now having the all-oral regimens for the treatment of drug resistant TB, which can span from nine to 12 months,” he added.

He said the country was looking forward to further reduction of the drug load for DRTB to about six months according to WHO recommendations.

The new treatment regimens now also have less side effects which also promote adherence to treatment.

Some of the common side effects experienced by patients of TB treatment include anorexia, nausea, abdominal pain, burning sensation in the feet and joint pain. The less common side effects include skin rash, jaundice, visual impairment and kidney failure among others.

Dr Mapuranga said the TB preventive therapy (TPT) had also experienced changes in the regimens which was contributing to increased uptake.

TPT is essential to reduce the incidence of TB disease among high risk individuals.

“We also want to appreciate the changes which took place in the TB preventive therapy whereby in the previous years, people used to take only Isonaizid, which was taken daily for six months.

“But in 2020, the Ministry of Health and Child Care adopted the use of shorter regimens which are equally effective, but with less side effects and which are also programmatically good to implement. We now have about three months of weekly combinations of Isonaizid and Rifapentin for people living with HIV as well as daily combinations of Isonaizid and Rifampicin for the treatment of latent TB amongst contacts who are children less than 15 years of age,” he added.

He said some Fluoroquinolones had also been introduced for contacts of people with DRTB.

“These are newer innovations which are a good step for the national TB control programme and we appreciate this because patients can take them with good completion rates and better outcomes,” said Dr Mapuranga.