South Africa does not have sufficient health infrastructure to cope with the TB epidemic, which is compounded by the fact that the spatial layout of many of these facilities hampers airborne infection-control of drug-resistant TB. Extensively drug-resistant (XDR) and multi-drug resistant (MDR) TB is a very serious problem in South Africa.
Deputy President Kgalema Motlanthe officially unveiled the plaque at the inauguration of a dedicated long-term accommodation unit for drug-resistant TB at Catherine Booth Hospital in rural KwaZulu-Natal
CSIR project leader Geoff Abbott (far right) at the inauguration of the Catherine Booth TB unit with (from left) Bruce Margot of the KwaZulu-Natal Department of Health; Deputy President Kgalema Motlanthe; and Dr Aaron Motswaledi, Minister of Health
In the country's fight against TB, Deputy President Kgalema Motlanthe recently opened a dedicated long-term accommodation unit for drug-resistant TB at Catherine Booth Hospital in rural KwaZulu-Natal. The CSIR was instrumental in supporting the design, development and construction of this unit.
"This is the fourth dedicated TB unit, specifically for the treatment of patients with drug-resistant strains of the disease, which has been completed according to CSIR specifications. A key requirement is to reduce the risk of patient-to-patient and patient-to staff cross-infection," explains Geoff Abbott, CSIR project leader.
The other three units that are already operational are at Manguzi Hospital (also in KZN), Kopano Hospital (in Welkom, Free State) and Tshepong Hospital (in Klerksdorp, North West).
By the end of June, two more TB units will be ready for occupational transfer, namely at Jose Pearson Hospital (Port Elizabeth, Eastern Cape) and Modimolle Hospital (in Limpopo).
The last three accommodation units currently being constructed for drug-resistant TB patients will be finalised before the end of this year. These are at Nkqubela Hospital (East London, Eastern Cape), West End Hospital (Kimberley, Northern Cape), and at Bongani Hospital (Hazy View, Mpumalanga).
The project has received at least R92 million from The Global Fund and more than R115 million from seven provincial Departments of Health where these newly-designed TB facilities are being constructed. The CSIR provided design and development guidelines and technical advice to ensure their successful roll-out.
For improved quality of life of long-term drug-resistant TB patients, the CSIR guidelines recommend provision for recreational spaces for sports, visitor areas, physiotherapy facilities, a business hub for patients and classrooms for younger patients.
CSIR architects and mechanical engineers use computational fluid dynamics (CFD) to study and model the airflow in buildings to improve the design for natural ventilation. "For improved TB units at hospitals, our focus was on developing low-cost and low-maintenance, yet fully functional facilities that will contribute to the prevention and control of airborne TB infection," says Abbott.
"The CSIR is the implementing agent on behalf of the national Department of Health, which included both technical and financial management. We work with the provincial teams, firstly by teaching them about airborne infection control, recommending some design ideas, and then having a number of working sessions to fine-tune their designs, which included the CSIR doing CFD modelling to test the designs. In this way, we aim to empower the teams by giving them an understanding of the dynamics of designing to reduce the risk of airborne disease transmission," notes Abbott.
The sheer numbers of TB cases in South Africa are a stark reality - the country has the highest incidence rate for TB infection in the world, with over 70% of TB patients being co-infected with HIV/Aids.
Based on the R&D of this project, CSIR researchers have delivered numerous invited presentations at national and international conferences, with a number of research articles and reports being published.
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