Everything you need to know about Tuberculosis (TB) and who is most at risk
Durban - On March 24 the world commemorated World Tuberculosis (TB) day with South Africa - which has among the world’s highest infection rate of the disease at the forefront of the fight.
According to WHO’s Global Tuberculosis Report 2020, TB is still a major cause for ill-health and death, with an estimated 10 million people diagnosed with TB in 2019.
South Africa is among the 14 countries that have an exceptionally high burden of susceptible TB, TB and HIV co-infection and MDR TB (This is according to the World Health Organisation, 2017).
A TB Prevalence Survey conducted in 2018 indicated that TB prevalence for all forms and all ages in South Africa in 2018 was estimated at 737 per 100,000 population.
The estimated prevalence of pulmonary TB in males 15 years and older, was more than 1,000 per 100,000 population. This is approximately 1.6 times that of females, which is cause for concern – especially, given the fact that men generally prefer not to come to health facilities unless they are very sick, which needs to change.
So what is TB and the terms associated with it?
Below are excerpts from information gleaned from the KZN Department of Health.
TB versus Covid-19
Tuberculosis (TB) and Covid-19 are both infectious diseases that attack primarily the lungs.
Both diseases have similar symptoms such as cough, fever and difficulty with breathing.
However, TB has a longer incubation period with a slower onset of disease.
The World Health Organisation says that people who are sick from both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted.
TB is a disease that mainly affects the lungs, but can be found in any other body organ.
It is caused by a germ which can be found in the sputum coughed up by those that have TB of the lungs.
The germs usually destroy the soft tissue of the lungs, and this causes cavities (holes) in the lungs, resulting in difficulty with breathing, and blood can be coughed up. If untreated, TB can cause death.
Different types of TB
There are many different types of TB.
There is Pulmonary Tuberculosis; Pleural Tuberculosis; Skeletal Tuberculosis; Brain Tuberculosis; Bladder and Kidney Tuberculosis; Joint Tuberculosis; and Gastrointestinal Tract Tuberculosis.
What is MDR TB?
Multi-Drug Resistant TB (MDR TB) is a specific form of TB that does not respond to “ordinary” TB treatment. As a result it is difficult to treat and needs specialised treatment.
What Causes MDR TB?
MDR TB is caused by the development of TB bacteria, which have become resistant to ordinary TB drugs.
This occurs due to various reasons, including:
•As a result of inadequate or irregular management of "ordinary" TB - either by using inappropriate drug combinations or by using single drugs for "ordinary" TB.
•Being exposed to MDR TB by someone already infected, you can develop the same type of MDR TB; as well as,
•People defaulting or not completing their routine TB treatment.
XDR-TB, on the other hand, Extensively Drug-Resistant Tuberculosis (XDR-TB) is a form of tuberculosis caused by bacteria that are resistant to some of the most effective anti-TB drugs.
People may get XDR-TB in one of two ways. It may develop in a patient who is receiving treatment for active TB, when anti-TB drugs are misused or mismanaged, and is usually a sign of inadequate clinical care or drug management. It can happen when patients are not properly supported to complete their full course of treatment; when health-care providers prescribe the wrong treatment, or the wrong dose, or for too short a period of time; when the supply of drugs to the clinics dispensing drugs is erratic; or when the drugs are of poor quality.
The second way that people can develop XDR-TB is by becoming infected from a patient who is already ill with the condition. Patients with TB of the lungs can spread the disease by coughing, sneezing, or simply talking. A person needs only to breathe in a small number of these germs to become infected. However only a small proportion of people infected with TB germs develop the disease. A person can be infected by XDR-TB bacteria but not develop the active disease, just as with drug-susceptible TB.
How do people get infected with TB?
The disease is passed on from person to person. When a person who has TB coughs, sneezes or spits, germs are spread into the air from where they can be breathed in.
Fortunately, not all those infected contract TB, in most cases the germs are sealed off in the body and they do not multiply.
However, if the body's defenses can no longer control the germs, they become active and the person gets TB.
Who is at risk of acquiring TB?
•Close contacts of TB patients
•Children under 5 years
•People with diseases like diabetes and AIDS
•HIV positive persons with lowered immune systems
•People who take excessive alcohol and drug addicts
•People with poor nutrition and lack of food
•People suffering from stress; and
•People living in poorly ventilated, and over-crowded rooms.
The most common symptoms of TB are:
•A cough for more than 2 weeks; but if you are HIV+ a cough of any duration must be checked out immediately, Unexplained weight loss,
•Loss of appetite,
•Feeling tired and weak or coughing up blood.
•Even if you have only one or two of these symptoms you need to have a TB test.
It is very important for people to know these signs and symptoms of TB, so that they can present early to the health facility for a test and start treatment.
Information sourced from the TB Day speech of KZN MEC for Health Nomagugu Simelane