Doctor involved with TB treatment plans at Mediclinic garnered awards for TB advocacy

Posted on 2 July 2013

Having collected an international award in Washington for the work done by her tuberculosis (TB) treatment advocacy group, TB Proof, Dr Dalene von Delft, who used to be an emergency centre doctor at Mediclinic Vergelegen, was also named as one of Mail & Guardian’s 200 Young South Africans. The first award, from USAID, was presented to the group for distinguished work in the field of global health diplomacy, while the latter recognised Dalene as a young person making a valuable contribution to the future of the country in the health field. Dr von Delft still assists Mediclinic with the advocacy for TB treatment and prevention strategies.

“I am humbled by the article that appeared in the Mail & Guardian, as I do not think I did anything extraordinary. I am always glad when TB gets media attention, and I hope it helps to break down the stigma about the disease,” says Dalene.

According to the World Health Organization (WHO) multi-drug-resistant (MDR) TB is “a major public health problem that threatens progress made in TB care and control worldwide”, so much so that Time Magazine featured the disease on its March 4, 2013 cover to highlight the issue. Essentially MDR-TB is a strain that evolved due to the inability of patients to adhere to their treatment protocols. This includes discontinuing the prescribed drugs because they feel better or due to intolerable side-effects, poor insight into the treatment they are receiving, drugs not being available, difficulty in consistently accessing treatment facilities or inadequate monitoring of their treatment by healthcare workers. The result is strains of TB that have become progressively more resistant to treatment. MDR-TB is resistant to at least two of the most effective anti-TB drugs, takes up to two years to treat and, in South Africa, less than half of all patients are cured. Even more concerning is the emergence of extensively-drug-resistant (XDR-TB) strains against which the majority of TB drugs are ineffective. Many of these strains are therefore proving to be incurable (cure rates are under 30% for XDR-TB) and spread as easily as regular TB, meaning that anybody who is exposed to the bacteria could become sick.

TB Proof is part of a growing movement calling for more funding and research into treatment for TB, as the numbers of people contracting drug resistant (DR) TB grows worldwide, and not only in developing countries but also in first-world nations such as Britain and the United States.

Dalene’s involvement in lobbying for better treatment for occupationally-acquired TB sufferers is a result of her contracting the disease when she worked as a medical officer at a large hospital. What started out as persistent dry cough turned out to be something more sinister when she was diagnosed with MDR-TB. In all likelihood she was infected through working with patients who had the disease.

The 19-month treatment regime was traumatic. She had to take large amounts of drugs with terrible side effects including the prospect of going deaf, something that could be devastating to her medical career as doctors are reliant on stethoscopes, as well as listening to their patients to make a diagnosis. Dalene sought out alternative treatments and was extremely fortunate to be one of the first people in South Africa to obtain permission to use Bedaquiline, the first new drug developed to treat TB in 42 years, on compassionate grounds.

Once free of TB, her experience spurred her on, along with a number of similarly affected colleagues, to form TB Proof to create awareness about better treatment protocols for DR-TB and for advocating for new TB drugs to be made available in South Africa. The group also conducts seminars and workshops at faculties of health to inform students on how to minimise their chances of infection, and also lobbies healthcare employers to provide adequate TB prevention measures for their staff.

Dalene was recently invited to become a temporary adviser for the WHO and has just returned from Geneva, Switzerland where she participated in intensive discussions on the organisation’s post-2015 strategy to end TB.

“It was a great opportunity to motivate for change. My biggest dream is to see TB eliminated in my lifetime, and I will continue working towards that goal,” she concludes.

 

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.