A doctor looks at an X-ray of a patient during the examination process, testing for tuberculosis at a clinic in Langa. Picture: AP Photo/Schalk van Zuydam
A doctor looks at an X-ray of a patient during the examination process, testing for tuberculosis at a clinic in Langa. Picture: AP Photo/Schalk van Zuydam

TB Prevalence Survey: Higher proportion of HIV negative people have asymptomatic TB, report finds

By Viwe Ndongeni-Ntlebi Time of article published Feb 5, 2021

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South Africa has a high tuberculosis (TB) burden, including many people with undetected TB in the community. There is a high burden of TB in men rather than females.

According to the new TB Prevalence Survey released on Friday, an estimated prevalence of TB in South Africa is 737 per 100 000 population. Men, the elderly, 65-years and older, and people in the age groups 35 – 44 years are least able to access TB services.

People with TB symptoms often delay in seeking care which means that late presentation for care results in advanced and complicated TB disease, leads to avoidable hospitalisation and deaths.

A higher proportion of HIV negative people have asymptomatic TB than people living with HIV.

The survey is crucial in South Africa as TB is one of the country’s deadliest infectious diseases. The survey has key information in policies dealing with TB.

Deputy Health Minister Dr Joe Phaahla apologised for the delay in the release of the report. “I know when there’s such a delay there may be suspicion that people in government are trying to doctor the report. I can assure you, this is not the case.”

The Human Sciences Research Council’s Dr Sizulu Moyo said the aim of the survey was to enhance TB control in the South After by informing the National TB Control Programme.

The survey selected 110 clusters around nine provinces around the country, older than 15 years, over 53 000 participants were targeted, 35 191 participated.

Moyo noted that participation was lower among men and younger people and also those in urban areas compared to rural areas.

The survey also shows an estimated TB prevalence at 737 per 100 000. And about two thirds of participants with 1 or more symptoms, did not seek care at time of survey.

Minister of Health Dr Zweli Mkhize, said the report has been released while we are in the pandemic.

As a high burden country, South Africa continues to battle a TB epidemic. In addition, our rates of drug resistant TB, though declining, continue to pose a public health risk.

“There are many people with undetected TB in the communities. The implications of this is continued transmission. To break the cycle of transmission we need to extend services to communities through outreach programmes and sustain infection control practices from Covid-19.

“A higher proportion of HIV negative people have asymptomatic TB than people living with HIV.

“This key finding requires a shift in the way we achieve proactive health seeking behaviour,” said Mkhize.

He also noted that previously, we focused on symptomatic patients and those living with HIV. “We now need to encourage everyone to screen and test for TB to achieve elimination.”

Mkhize key recommendations emanating from the TB Survey Report included:

− Increasing access to TB screening and testing services through outreach programmes using mobile testing and X-ray facilities. These services should target the hard-to-reach populations.

− Routinely testing people living with HIV, household TB contacts and people previously treated for TB, irrespective of symptoms.

− Expanding the use of chest X-rays for TB screening at facility and community level. This was based on the results of a pilot study which is being conducted in 6 districts.

– The TB Health Check App has been developed and can be accessed by dialling *134*832*5# or send "TB" to +2 76 001 23456 on WhatsApp. This App provides an easy way for everyone to screen themselves for TB.

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