Again
Tuberculosis (TB) was one of the main topics. The Department of Health has
published new guidelines for this disease this year. The incidence
has risen from approximately 200,000 new cases in 1995 to more than
500,000 new cases in 2012. The underlying reason for this increase is
the advancing AIDS epidemic because those living with HIV have a
weakened immune system and are therefore much more susceptible for
Tuberculosis.
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| Home care givers during a group assignment |
Our home
care givers can play an important roll in the fight against
Tuberculosis. They can contribute to the early recognition of
infectious patients, e.g. by doing a thourough screening for all
close contacts of a TB Patient who are living with him/her in the
same house hold. The prophylactic treatment with Isoniazid of all
children under five years who stay together with a smear positive TB
patient prevents many new infections.
An even
greater challenge than case finding is to encourage the patients to
remain on treatment for at least six months in order to get cured.
Wrong perceptions of the disease, ignorance, alcohol abuse and side
effects of the TB drugs are important factors that lead to defaulting
the treatment. This does not only lead to the flaring up of the
infection and to infecting other people but may even result in the
threatening development of resistant strains against the standard
treatment( Multi Drug Resistance -MDR).
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| Undine Rauter shows how to do exercises with patients who have a hemiparesis after a stroke |
The
greatest challenge for our home care givers is whether they succeed
in convincing the patient that the infection with Tuberculosis may go
together with HIV Infection. Seven of ten patients who suffer from
Tuberculosis are HIV positive. A HIV test is therefore mandatory.
According to the new guidelines all patients suffering from TB have
to start with livelong Antiretroviral Treatment (ART) within weeks
after the initiation of TB Treatment.
Beside
these two long term priorities HIV and TB many other topics were
discussed during the workshop. Among them was the input from Undine
Rauter and her team from Gelukspan how to do exercises with patients
who have a hemiparesis after a stroke.
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| Traditional "braaivleis" at the last evening of the workshop |
