Each year, we commemorate World TB (Tuberculosis) Day on 24 March, designed to build public awareness about the global tuberculosis (TB) epidemic and efforts to eliminate the disease.
In South Africa, we need better collaboration across sectors, including healthcare, social services, and community organisations, to provide comprehensive support to vulnerable populations
History of Tuberculosis
Where does TB come from and why have we not eliminated it yet like smallpox or polio?
- It is believed that the genus Mycobacterium, which includes Mycobacterium tuberculosis, originated more than 150 million years ag
- The first human infections with TB are estimated to have occurred about 9,000 years ago
- Egyptian mummies from around 2400 BC show skeletal deformities typical of TB. Written records of TB-like diseases date back to 3300 years ago in India and 2300 years ago in China
- Dr. Robert Koch identified Mycobacterium tuberculosis as the causative agent of TB in 1882
How is TB Spread?
TB is now known to spread through the air when an infected person coughs or sneezes, releasing TB germs that can be inhaled by others.
Awareness for Tuberculosis
TB awareness is crucial because it’s a preventable and curable disease, but early detection and treatment are essential to prevent its spread and serious complications, including death. Raising awareness helps people understand the symptoms, seek timely medical attention, and take preventative measures.
How Does TB Manifest?
Tuberculosis (TB) can manifest in different ways depending on whether it is active or latent and where in the body the infection is located.
Active TB disease occurs when the immune system cannot control the infection, allowing the bacteria to cause disease in the lungs or other parts of the body. Symptoms of active TB disease include:
Pulmonary TB: Common symptoms include a persistent cough lasting more than three weeks, chest pain, coughing up blood or sputum, fever, chills, night sweats, weight loss, and loss of appetite
. Specific examples include:
- TB meningitis: Headache or confusion.
- TB of the spine: Back pain.
- TB of the kidneys: Blood in the urine.
- TB of the lymph nodes: Swelling under the skin
Extrapulmonary TB
Extrapulmonary TB accounts for a significant and increasing proportion of TB cases, particularly in immunocompromised individuals like those with HIV. Symptoms vary based on the affected organ but often include fever, chills, night sweats, weight loss, and pain near the site of infection. Diagnosis can be challenging, especially without pulmonary involvement, and may require invasive procedures.
Extrapulmonary TB – TB of the Bone in the Knee
Mabusi Kgwete, OJA Board Secretary, was diagnosed with extra-pulmonary TB- TB of the bone in the knee in January 2023. After many trips to the clinic and a few wrong turns, she was eventually put on TB treatment for 12 months.
“When the doctor told me that I had TB, I was shocked and scared mainly because of the TB treatment side effects. I was in a lot of pain in my knee; part of me knew I had to adhere to the treatment to cure TB. The treatment was brutal. I was taking five pills a day during the extensive phase, which made me feel so sick, Mabusi explains.”
Extrapulmonary tuberculosis (TB) in the knee, also known as tuberculous arthropathy, presents with several characteristic symptoms and radiological findings.
TB in South Africa
Tuberculosis (TB) remains a significant public health challenge in South Africa, which is one of the 30 high-burden TB countries globally
- Incidence and Prevalence: In 2023, the incidence of TB in South Africa was reported at 427 cases per 100,000 people. The prevalence of all forms of TB was estimated at 737 per 100,000 population in 2018.
- TB and HIV Co-infection: South Africa’s TB epidemic is exacerbated by a high HIV co-infection burden. The scale-up of antiretroviral treatment has contributed to a decline in TB incidence among people living with HIV.
- Reduction in TB Cases: Between 2015 and 2022, TB incidence declined from 552,000 to 280,000 cases, representing a 49% reduction. However, TB remains a leading cause of death, with an estimated 54,200 deaths in 2022
- Where are we going with TB Awareness?
In 2023, TB killed about 56,000 people in South Africa.
No Need for these Deaths
“There is no need for these deaths, TB is curable. Those who are diagnosed have to take their treatment every day and get support from loved ones to ensure they complete it. TB stigma is also a contributing factor, we don’t talk openly about TB infection because people are scared that they will be infected,” says Mabusi.
As a TB survivor, Mabusi has taken it upon herself to raise awareness of the extra-pulmonary TB (EPTB), tuberculosis that affects organs other than the lungs, including lymph nodes, pleura, bones, joints, and the genitourinary system.
“The treatment I took was the same as for pulmonary TB, but the duration may vary depending on the affected organ,” continued Mabusi.
“My life has changed. I am mostly indoors because I am on crutches and conscious of what people will say. I have a burning sensation on my feet, and my eyesight is deteriorating due to TB treatment side effects. I don’t think the knee replacement surgery scheduled for late this year will ever make me better psychologically or emotionally. I may be TB-free, but I will carry TB for the rest of my life!”
Yes! You and I can end TB by ensuring that we screen for TB, take TB treatment as prescribed, support those who are on TB treatment, and be part of the conversations to break TB stigma.
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