10 facts about TB

Tuberculosis (TB) is the leading cause of death among South Africans, with one person succumbing to the disease every hour.

Despite the availability of effective treatments and much progress having been made in fighting the disease, 450 000 people develop TB annually.

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South Africa is one of 30 high burden TB countries that collectively account for 87% of cases worldwide.

According to the WHO 2021 Global TB Report, the Covid-19 pandemic has reversed years of global progress in tackling TB and, for the first time in over a decade, TB deaths have increased.

What is TB?
It is caused by a specific germ called Mycobacterium tuberculosis. These germs are found in the sputum (a mixture of saliva and mucus) of someone with TB

How is TB contracted?
The germs spread into the air via microscopic droplets if an infected person sneezes, coughs or spits on the floor. The incubation period is six weeks, and each person with TB can spread the disease to another 15 individuals over the course of a year

TB symptoms in children
A cough for a couple of weeks, loss of energy and quite often a mild fever

TB Symptoms in adults
· Excessive coughing – a cough that has been present for more than three weeks and is productive, in other words, when you cough up phlegm
· Blood in sputum
· Lack of appetite
· Weight loss or a loss of more than 5kg without a diet
· Low grade fever
· Night sweats
· Chills

Who is most at risk of contracting TB?
People living with HIV (especially those newly diagnosed or not virally suppressed), living in the same house as someone who has had or has TB; anyone who has had active TB in the last two years; those with diabetes; residents of informal settlements; children under five; the undernourished; alcoholics; smokers; mineworkers; prisoners, and pregnant women

Is there enough research and development for TB drugs?
The short answer is no. Countries with resources, funds and technical capacity (developed countries) have not invested in the field of TB because the disease has not affected them. Over 95% of TB cases and deaths occur in developing countries where living conditions are often poorly ventilated and over-crowded

Can you have TB but not be sick?
TB can be ‘latent’; in other words, you have TB in your body but it is not active. You aren’t ill and you can’t spread it. However, if your immune system becomes weak for some reason, the TB becomes active and will make you ill. Having HIV/Aids is a key factor in the TB epidemic which is why it’s imperative that the almost six million people living with HIV are screened and treated

How is TB diagnosed?
The current process of testing most of the population is a long one. The Mantoux tuberculin skin test (TST) and blood tests do not differentiate between latent and active TB, which means a sputum sample needs to be taken, or a chest X-ray. This is both costly and time consuming. A quicker, cheaper method of testing would certainly assist to diagnose TB.
Diagnosis is complex (particularly for those living with HIV), since many symptoms are similar to those for other common diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics

Treating TB
Treatment still includes many of the original antibiotics that were developed in the 1950s and ’60s. While newer antibiotics have been introduced, they are still used in combination with the originals whose side effects cannot be ignored. Similarly, BCG is still the only known TB vaccine administered to children in developing countries

New treatments for latent TB
Some good news from senior technical advisor, Dlamini-Miti TB at health NGO Right to Care, says, ‘Since July 2020, a latent TB prevention treatment called 3HP has been piloted. It is considered a game changer because treatment is shorter, less toxic, promotes better adherence, has a higher barrier to resistance and is safe with first-line antiretroviral therapy.’

Source: Dr Morgan Mkhatshwa, head of operations at Bonitas Medical Fund

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