World TB Day is commemorated annually to raise public awareness on tuberculosis (TB) and to strengthen efforts to prevent its spread. Today, Deputy President David Mabuza leads the commemorative event in the Frances Baard District, Northern Cape, which currently holds a high number of TB cases in the province.
This year’s national theme for World TB Day is “Invest in Action to End TB Now! Get Screened. End Stigma. Save Lives.” This call asks leaders to dedicate sufficient resources for TB response and urges South Africans to invest in their personal health through existing pharmaceutical and non-pharmaceutical interventions available to support TB patients and end TB.
TBCHECK
The National Department of Health has partnered with The Clinton Health Access Initiative (CHAI), University of Stellenbosch and The Praekelt Foundation to scale up the use of the TBCheck mobile platform which provides an easy mechanism for TB self-screening.
The platform, which is accessible via WhatsApp and USSD, guides users through a series of questions about themselves and any symptoms they may be experiencing. The platform then provides suggestions on whether users should proceed to test for TB, monitor symptoms and it also alerts the user to their personal risk profile (high, low, etc.)
Dr Yogan Pillay (CHAI South Africa Country Director) said, “TBCheck brings screening closer to those who need it most. The screening service offers the potential to accelerate TB case finding and reduce the time to diagnosis, treatment, and care. It moves away from the historical reliance on passive case-finding towards a behavioural change model where citizens can self-manage their desire to find out more about their TB status immediately.”
This platform is accessible through both USSD (*134*832*5#) and WhatsApp (0600 123 456)
THE DISEASE
TB is the world’s deadliest infectious disease, claiming three lives every minute. South Africa (SA) ranks 8th amongst the top 30 high burden TB countries, accounting for 3% of all TB cases worldwide. People infected with TB bacteria have a 10% lifetime risk of falling ill with TB.
However, persons with compromised immune systems, including people living with human immunodeficiency virus (HIV), malnutrition or diabetes, and people who use tobacco, have a much higher risk of falling ill. The national prevalence survey has shown that TB burden is ~1.6 times higher among males than females. Similarly, the prevalence of TB was found to be higher among individuals aged 35-44 years and those above the age of 65.
TB bacteria primarily targets the lungs. The disease is transmitted through the air from person to person via droplets from the throat and lungs of people with active respiratory disease.
It is important to understand that in healthy people, infection with Mycobacterium tuberculosis often has no symptoms; this is called latent TB infection. With 554 cases per 100 000, SA has the second-highest TB incidence rate globally.
TB is the leading cause of death in the country and the high rate of HIV co-infection continues to accelerate the impact of the epidemic. Given the high rate of TB in South Africa, there is an urgent need to curb transmission, but the means of communication used to impact TB screening and testing must be changed if we are to live in a healthier society.
TB SURVIVOR: IT’S NOT A DEATH SENTENCE
When a person develops active TB disease, the symptoms, which include cough, fever, night sweats, and weight loss, may be mild for many months. This can lead to delays in seeking care, and subsequent transmission of the bacteria to others. People with active TB can infect 10 to 15 additional people through close contact over the course of a year.
Stigma and discrimination associated with TB are among the greatest barriers to preventing care-seeking and as result, causing further infections. This means that people living with TB do not access adequate care, support, and treatment in time. Studies show that women bear the highest burden of stigmatising behaviours.
Valentine Plaatjie-Dlamuka was diagnosed with TB in 2018.
“I experienced stigma, even from family and friends. But I had to educate people around me because, unfortunately, most people still think people who contract TB are HIV positive. I lost weight. And when people see you losing weight and coughing, they stigmatise you.”
Valentine says when she got diagnosed, she did not know where to start.
“The nurse at the clinic sat me down and explained to me that it’s not the end of the world, as long as I took my medication and led a healthy lifestyle. TB is not a death sentence. It’s curable. Go for check-ups and don’t default. Eat right and surround yourself with positive people.”
TB IS CURABLE
Dr Thulaganyo Motaung says TB is curable, with the right treatment.
“Adherence to treatment is important with proper follow-ups as the treatment is long – six months for most of the time, unless it is a resistant infection. In that case, the treatment is usually nine to 12 months.”
As we commemorate World TB Day, we ask, how does a nation already overwhelmed by socio-economic stresses release itself from the grip of fear, and begin to view TB detection and treatment as an opportunity to live a quality life? AND how can detection of TB be done without reawakening the very fears and the conditions of the mind that have allowed it to thrive thus far?
The NDoH has prioritized TB Check as a core component of its Recovery Plan. This comes at a favourable time when large majority of the population are advancing with technology through smartphones. It is easy to use and zero-rated, so, all users can access care for free.
