Article provided by Bonitas Medical Fund
Ten people die in South Africa every hour from Tuberculosis (TB). Even though effective treatments are available and there has been considerable progress in fighting the disease – about 450 000 people develop TB every year. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, talks about the state of our nation in terms of TB, the leading cause of death in our country.
The effect of TB on your business
If you, as an owner of a small business or one of your employees contracts TB, it could have a detrimental effect on the business in terms of productivity – due to absenteeism – as well as direct and indirect expenses.
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 the person sneezes, coughs or spits on the floor. The incubation period is 6 weeks and each person with TB can spread the disease to another 15 individuals over 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
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 are 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?
Currently the 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 quite 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.
Current treatment for TB still includes many of the original antibiotics that were developed in the 1950s and 1960s. 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 Right to Care, says, ‘Since July 2020, a latent TB prevention treatment called 3HP for 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.’
It is important to remember that TB is curable, and we urge you to make your staff aware of the impact of TB on their health and those around them and explain that it is treatable. If you know someone who is showing any of the symptoms and you suspect they have TB, encourage them to go to the nearest clinic to be tested. There is no cost involved and if they are positive, it is very important for them to follow the treatment regime right through to the end.