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Most of us have by now heard that those with preconditions like HIV and TB are more susceptible to the coronavirus, here’s how to manage it.
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Experts have said that people with preconditions are more susceptible to coronavirus. So if you’re suffering from TB, HIV or even diabetes, you should be extra careful. If you haven’t been tested for the above conditions, you might want to take care of that too.
On Thursday 12 March, Health Minister Zweli Mkhize confirmed South Africa has 17 confirmed cases of the virus — officially named SARS Coronavirus 2 (SARS-CoV-2).
According to Bhekisisa at the Centre for Health Journalism, the virus gets its name from its similarity to the virus responsible for the 2003 outbreak of severe acute respiratory syndrome in China. The World Health Organisation (WHO) also confirmed the coronavirus a global pandemic on Wednesday.
The spread continues to persist at a rapid rate, it may hit people with underlying health conditions such as HIV and TB, and who are not on treatment, the hardest — according to the heads of local HIV and TB research organisations. Similar risks may hold true for those living with other chronic illnesses.
Salim Abdool Karim is the director of the Durban-based Centre for the Aids Programme of Research in South Africa and a global health professor at Columbia University in the United States. He says that coronavirus is too new to know much about its potential impact on people with HIV, but other viruses — such as measles or influenza — can provide clues.
If those viruses are anything to go by, those with HIV, and who are not on treatment, will be among the most at risk.
“If an HIV-positive patient is on antiretrovirals, then their response will be pretty similar to what an HIV-negative patient’s response would be based on what we know from other infections,” he said.
Between eight and almost 15% of people older than 70 who contracted the virus in China’s Hubei province died. Today, about four out of every 10 people living with HIV in South Africa are still not on antiretrovirals, the latest HIV household survey by the Human Sciences Research Council revealed.
In Johannesburg, the organisation Right to Care provides HIV services. CEO Ian Sanne agrees with Abdool Karim saying:
“People on antiretrovirals need to make sure they’re taking their antiretrovirals and then I think there’s no reason to worry more than the general population,” Sanne told Bhekisisa.
“What we’re worried about are people who are HIV positive and not yet diagnosed. Now is the time to know your status and start treatment,” added Sanne.
South Africa is among 30 high burden countries that account for almost 90% of the world’s TB cases, according to the WHO’s 2019 TB report. In 2019, more than half of the country’s 301 000 TB cases were among people infected with HIV.
Karim said it’s not clear how the new coronavirus will impact people co-infected with HIV and TB, given that both TB and coronavirus affect the lungs.
Statistics South Africa’s 2016 data shows TB was responsible for about 30 000 deaths in 2016 and the condition remains the leading cause of natural death in South Africa.
Senior specialist scientist at the South African Medical Research Council’s NCD Research Unit, Nasheeta Peer says it’s difficult to predict how people with NCDs such as diabetes, which weaken the immune system, might be impacted by the coronavirus.
Peer explains that people with diabetes will be at increased risk compared with the general population, “but if their diabetes is uncontrolled, which is possible even when taking medication for diabetes, then the risk may perhaps be greater”.
The International Diabetes Federation estimates that about 450 million adults were living with diabetes worldwide in 2017, but almost half these cases were undiagnosed.
Data from Stats SA notes how diabetes is the second leading cause of natural death in South Africa after TB, with about 25 000 people who died in 2016. People with diabetes are three to four times more likely to develop TB, a 2010 research review published in the journal Tropical Medicine & International Health showed.
Director of the South African NCD Alliance Vicki Pinkney-Atkinson, says if the new coronavirus begins to spread in South Africa, her main concern is people with NCDs who need medication, but could potentially put themselves at risk of contracting the virus by queuing in long lines at public clinics to do this.
In 2012, the national health department introduced a system to deliver chronic medications to allow patients to pick up their medications at designated pick-up points outside of health facilities.
About 3.1-million patients are now enrolled in the project, called the Centralised Chronic Medicine Dispensing and Distribution programme, according to presentations made before Parliament earlier this year. Patients can now pick up medication at more than 800 points around the country despite the programme’’s challenges with costs and patient tracking.
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