South Africa is on the WHO's list of 30 high-burden tuberculosis countries and has one of the highest incidence rates of notified tuberculosis in the world.
According to the report written by Sizulu Moyo and published in the Lancet Infectious Disease entry, the first national tuberculosis prevalence survey in South Africa confirmed that the disease is still widespread, with an estimated prevalence of 852 cases per 100 000 people.
It is also more prevalent in men and those who are 65 years or older.
The report also highlights how, despite the massive expansion of HIV diagnosis and treatment, tuberculosis still affects people living with HIV in South Africa at one of the highest rates in the world, with an estimated prevalence of 1734 cases per 100 000 people, or almost twice as many as HIV-negative people.
Around 304 000 persons in South Africa contracted TB in 2021, according to the World Health Organization's Global TB Report. Moreover, multi-drug-resistant TB (MDR-TB) and TB/HIV co-infection rates are highest in South Africa.
Statistics show that in 2019, a total of 58 000 people died of TB in South Africa. Despite the high death rate, TB is still relatively misunderstood and not often discussed.
March 24, 2023, is recognised as World TB Day and serves as a global platform to increase awareness, improve education, and catalyse individual, group, and governmental action. Even so, everyone must be aware of this disease and how they can avoid and screen for it.
The First National TB Prevalence Survey (2018) discovered that the significant burden of undiagnosed disease in communities is due to delayed health-seeking behaviour among TB patients.
We are all aware of the various challenges that health systems are having, which have a detrimental influence on health outcomes, particularly the early detection and efficient treatment of TB cases, said Ian Wakefield, General Manager of Becton Dickinson BD Africa.
"We can approach this major contributor to South Africa’s burden of disease with new energy and step-up awareness and TB services to all communities."
What is TB?
Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can affect other parts of the body. It is a significant public health problem globally, but it is particularly prevalent in South Africa.
Why it is important to get tested for Tuberculosis (TB)
One of the most significant challenges facing the South African healthcare system is the large number of undiagnosed and untreated cases of TB. Undiagnosed TB can lead to the spread of the disease, which can have a devastating impact on individuals and communities. Testing is critical in identifying people with TB so they can start treatment promptly and prevent the spread of the disease.
Compared to latent TB, active TB has a higher burden of TB bacteria and acts as an infection source for contacts. Latent tuberculosis infection is the state in which the person is infected with Mycobacterium tuberculosis but does not have any clinical symptoms, and the infection is not detected through x-ray or microbiological testing.
TB testing and screening are essential for public health. TB can spread from person to person easily and can be fatal if untreated. It is important to get tested if you have any of the following symptoms:
- General feelings of sickness or weakness
- Unexplained weight loss
- Fever
- Night sweats
- Coughing with/without coughing up blood
- Chest pain
“TB affects hundreds of thousands of South Africans. Our responsibility is to create awareness and reduce stigma as this would help encourage individuals to go for screening,” said Wakefield in a statement.
Having effective treatment and detection strategies for TB is crucial in addressing the epidemic in South Africa.
We know our healthcare system has challenges in providing adequate testing to everyone at high risk. What needs to happen to alleviate the burden on the healthcare system is to invest more in advanced testing methods, such as GeneXpert (which uses a sputum sample and can give a result in less than 2 hours), to provide accurate diagnoses, especially among people with weakened immune systems.
It will help prevent unnecessary treatment and also ensure that TB is promptly identified and treated, which will ultimately reduce the spread of the disease.
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