IT WILL be many years before SA reaches the World Health Organisation (WHO) target of curing 85% of newly diagnosed tuberculosis (TB) cases if measures to fight the epidemic are not stepped up, Margo Uys, co-chairwoman of the third South African TB Conference, said on Friday.

SA has the third-highest number of TB cases in the world after India and China, and the second-highest incidence per 100000 people after Swaziland. TB is a leading cause of death in SA.

The Department of Health's national strategic plan for 2012-16 cites the reduction of the number of new TB infections and deaths from TB by 50% as a top goal.

Dr Uys said on Friday at the conference in Durban that in the past four years the percentage of people cured of TB had risen from a low of about 50% to close to 70%, but reaching the WHO's target was proving to be a struggle.

Dr Uys also said the incidence of TB might be underreported in SA. The disease carries a stigma in some communities which view it as associated with HIV/AIDS. There is a reluctance to go for tests in some communities.

Because so many HIV/AIDS infected people also develop TB, the integration of medical facilities and clinics to deal with both diseases was essential to curb the epidemic. Integrated facilities need to also be managed in such a way as to protect HIV/AIDS patients and hospital staff from the bacillus at medical facilities.

Dr Bhavesh Kana, head of the University of Witwatersrand Centre of Excellence for Biomedical TB Research, said improving the cure rate would need more government and community support - treatment takes six months while treatment for drug-resistant strains can take 18-24 months.

He said it was too early to predict how successful the GeneXpert machines would be in SA - the first of the automated molecular analysis machines was brought to SA last year. It can detect TB and multidrug-resistant TB in two hours, without fear of contamination. Previously it used to take three to five months to know if someone was infected.

Dr Kana said new drugs for TB were being developed in other countries that offered hope of dealing better with the TB epidemic, and many clinical trials were under way in SA.

este@bdfm.co.za