A pregnant 24-year-old woman at Harry Gwala Clinic had a history of recurring TB. After being treated in 2020, 2021, and again in May 2024, her last treatment outcome was marked as “completed” in her patient file. However, during a routine file audit in June 2024, the ACCELERATE 2 THINK team found she had been re-initiated on TB treatment for a fourth time based solely on a positive TB NAAT genetic-based test. Given her recent TB history, TB management protocols require a bacteriological culture test for confirmation of bacterial growth before re-treatment.
THINK team doing file audits at a health facility in Fezile Dabi district
Recognizing this oversight, THINK took immediate action. The Clinical Nurse Mentor reported the case to the District Coordinator, who escalated it to the Department of Health’s DR-TB Medical Officer. The Medical Officer halted her treatment until a TB culture test could be performed. THINK coordinated the patient’s transfer to Fezi Ngubentombi Hospital for assessment, where a sonar instead of an x-ray was conducted due to her pregnancy.
The culture results came back negative for TB, confirming that she did not need any TB treatment, and that the team’s intervention was a success. The patient expressed relief in a follow-up call, sharing that her cough had subsided, allowing her to focus on her pregnancy.
This story underscores the importance of adhering to standardized TB management protocols, particularly in high-burden clinics. THINK follow-up mentorship to Healthcare workers at Harry Gwala reinforced the need for proper diagnostic procedures, ensuring that healthcare workers are equipped to manage complex TB cases effectively and minimize risks associated with mismanagement.