Since the outbreak of Coronavirus the Gauteng Department of Health (GDoH) has observed an increase in the number of TB and HIV patients that have defaulted on their medication. Thishas exacerbated the loss-to-follow-up (LTFU) rate of TB and HIV patients.
TB and HIV has remained a challenge nationally since the beginning of the health programmes owing to a number of factors such as high mobility. Some patients gave incorrect and unreliable addresses due to fear of stigma around TB and HIV.
According to statistics the approximate number of patients that failed to collect their TB medicines is 1 090. Meanwhile the number of patients that failed to collect their antiretroviral medicines is approximately 10 950. Since the lockdown the average percentage reduction in medicine collections for TB is 1.4% and 19.6% for HIV.
Hence the department has developed and is implementing a track and trace plan to locate patients that have not come to collect their treatment and manage them accordingly. Through the Ward Based Outreach team’s patients are followed up and given their treatment.
The anticipated impact of treatment gaps for TB and HIV/Aids because of the lockdown measures are supply and transportation of medicines may be disrupted by flight cancellations and imposed travel restrictions.
Meanwhile the unavailability of medicines may lead to treatment interruption which subsequently cause drug resistance and deterioration of patients’ health. Patients that do not comply with treatment remain vulnerable and may be susceptible to other opportunistic infections.
The difficulty of managing patients with unsuppressed viral loads due to treatment interruption is one amongst other problems clinicians may have. Such patients may end up developing complications such as Immune Reconstitution Inflammatory Syndrome (IRIS) and many other illnesses. Those requiring follow up for bloods are advised to report to the facility.