World TB Day

Every year on the 24th March, the world observes Tuberculosis (TB) Day. TB is a major public health concern in many parts of the world. Although it is curable at relatively low-cost when managed properly, nearly one-and-a-half million people mostly in developing countries are dying of TB each year. Thus “TB is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent”

What is TB?

TB is a disease caused by germs ‘Mycobacterium tuberculosis’, that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die  if they do not get treatment.. Symptoms of TB disease of the lungs include coughing, chest pain, night sweats and coughing up blood. Symptoms of active TB disease in any other part of the body include feeling sick or weak, weight loss, fever, and night sweats. TB germs are released into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment.

TB Disease Burden across the World

In 2011, the World Health Organisation (WHO) reported an estimated 8.7 million new cases of TB and 13% are co-infected with HIV. During the same period, 1.4 million deaths were reported, of these deaths, approximately one million were among HIV-negative individuals and 430 000 were among people living with HIV. TB is reported to be one of the top killers of women, with 300 000 deaths among HIV-negative women and 200 000 deaths among HIV-positive women. Geographically, the burden of TB disease is the highest in Asia and Africa.

TB Disease Burden in South Africa

HIV, AIDS and Tuberculosis contribute significantly to the burden of disease faced by South Africans. In 2011, South Africa had about 0.4 – 0.6 million incident cases of TB and an estimated TB incident rate of 993/100 000 population. South Africa is one of the 27 high MDR-TB burden countries. In 2011, there were an estimated 1.8% of new TB cases with MDR-TB.

TB Disease Burden in the South African Mining Industry

TB incidence in the mining industry has increased exponentially with HIV every year. In 2008, the incidence of TB in the mining industry was 948 per 100 000, and estimated to be 3000 – 7000/100 000 in the gold mining sector. The South African mining industry has long been associated with exceptionally high rates of TB attributable to prolonged exposure to silica dust, overcrowding and poor ventilation, a high HIV prevalence associated with risky sexual behaviour, casualisation of labour, inadequate knowledge of worker rights and a fragmented health system in the provision of integrated HIV/TB services.

TB Disease Burden in Healthcare Workers

There is limited information on TB data in healthcare workers (HCWs), but available recent studies have shown that TB poses a major public health threat especially in health care settings. A study conducted in South Africa by the University Research Co. LLC (URC) and the Desmond Tutu Tuberculosis Centre (DTTC) to determine the incidence of TB in HCWs in selected healthcare facilities found that the average TB burden amongst HCW in five provinces was 2% as compared to 0.9% in the general population. Implying that HCW are up to 3 times more likely to acquire TB. Another study by O’Donnell et al found that HCWs had a 5 to 6-fold increased rate of hospital admission with MDR-TB or XDR-TB compared to non-HCWs.

Can TB be cured?

Yes TB can be cured, TB disease can be treated by taking TB medication (pills) for 6 to 12 months. It is very important that people who have TB disease finish all of the medicine, and take the medicines exactly as directed by HCWs. If the medicines are not taken correctly, the medicines might not work, people can become sick again and the people can get drug resistant TB.

What Should I Do if I think I Have TB Disease?

If you think you have TB, visit your nearest clinic for a FREE TB test. The HCWs in the clinic will ask you to cough and spit phlegm into a container for laboratory testing of the phlegm, to check for TB. If you have TB, the clinic will give you medicines to take for about 6 to 12 months. HCWs and DOT (direct observation of treatment) supporters will help you take your medicines everyday for as long as you need. Do not stop your treatment, even if you feel better. The TB germs will stay in your body for a long time after you feel better, as such you must take the medicines until HCWs ask you to stop.