TB remains a significant health problem in South Africa. Why is this the case, and how can you prevent getting sick?

Tuberculosis (TB) has had a long-standing, devastating presence in our country. Every year, more than 304 000 South Africans contract the infectious disease, and about 56 000 lives are lost. Of course, the gravity of the situation extends beyond mere statistics.

Each number represents a story of someone who struggled to shake a preventable, treatable infection. To commemorate World TB Day (24 March), we delve into the challenges posed by the disease – and what you can do to stay healthy.

TB is caused by bacteria called mycobacterium tuberculosis. This germ most commonly affects the lungs, with symptoms that include:
  • Persistent coughing
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Weight loss
  • Chest pain
TB can also affect other parts of the body, such as the bones, lymph nodes, joints, skin and gastrointestinal tract.

In the 19th century, TB (or ‘consumption’ as it was called) reached epidemic proportions in industrialised countries. The disease was difficult to control due to ineffective treatments, and many feared contracting the life-threatening ‘white plague’ (so-called due to the pale, thin appearance of those affected).

  • Bloody Cough
  • Fever Chest Pain
  • Weight Loss
  • Chills
  • Night Sweats
  • Fatigue Long-Term Cough

Even if you feel and look healthy, you could have a latent TB infection. This means you have the bacteria in your body but it’s in a dormant or inactive state. Only 5% of people with latent TB develop active TB within 18 months of infection.

Today, TB is both preventable and treatable. The development of antibiotics in the mid-20th century led to a significant decline in TB death rates worldwide. In developed countries, tuberculosis went from being a major public health concern to a relatively rare disease.

Yet, in 2024, TB is still rife in South Africa. And, yes, many of us still fear getting sick. Factors that contribute to our high TB numbers include:
  • A high prevalence of HIV: Those living with HIV have a higher risk of getting TB. Their odds of survival are also lower.
  • Poverty: People who struggle to make ends meet don’t always seek medical care in time. Poor nutrition also often means TB treatment is less effective.
  • Covid-19: The recent pandemic disrupted our national TB services. As a result, fewer people were diagnosed and treated in time.
  • Multi-drug-resistant TB: Our health authorities are very worried about our high rate of MDR-TB. “People who are diagnosed with TB and started on treatment usually feel better within the first two weeks,” says Dr Heidi van Deventer, a research officer at the Desmond Tutu TB Centre in Cape Town.
“As a result, many stop taking their medication [before they have gotten rid of the infection], which can lead to the TB mycobacterium becoming resistant to first-line TB drugs (the standard treatment). Drug sensitive TB can then become drug-resistant TB, which can be tough to treat.”

TB is primarily spread from person to person through the airborne transmission of bacteria (such as when an infected person coughs). One of the best ways to prevent the spread of the disease is to ensure there is good ventilation wherever you are – in the car, bus, taxi, house or workplace.

Open those windows. “If you have TB, it’s critical to take your medication exactly as prescribed and to not skip doses,” Dr Van Deventer advises. “If there are children under the age of five in the house, and someone who lives there has TB, it’s important to take the little ones to the local clinic or doctor for preventive treatment.”

Healthcare workers and anyone with a condition that compromises their immune system are also at higher risk. This includes cancer patients and those on immune suppressive medication. Getting TB symptoms checked out sooner rather than later is important.

As with any health condition, early detection can help prevent serious disease. “If you are experiencing the symptoms listed (on page 39), you should get tested. This is particularly important if you live with someone who has TB, but it’s still important if you don’t,” says Dr Van Deventer. “Tuberculosis is very common in South Africa, especially in our densely populated urban areas.”

Healthcare practitioners now primarily use PCR testing for TB. This simple, quick test detects the genetic material of the TB bacterium, and is available for free at all public health facilities and via private laboratories for a fee.

Words by: Carine Visagie
Main Illustration & Photo: Gallo/Getty Images

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