Tuberculosis (TB): Know the facts

TB has large-scale implications for the health of ordinary South Africans and is far from being defeated.

04 March 2014
by Kassabaine Petersen

As an airborne disease, tuberculosis or TB can be contracted anywhere – at work, church, the shopping mall… but mostly it occurs where people share cramped living conditions, where ventilation is poor and communities are even poorer. But don’t be fooled, it can affect anyone. It usually starts with an incessant, wracking cough and damage to the lungs, and as the infection spreads, the body withers and wanes. If left untreated, tuberculosis can very quickly mean the end of the road for patients.

How the disease is spread

If you breathe in the bug, one of three things could happen:

  1. If you’re healthy, eat nutritious foods and get regular exercise, your immune system, if strong enough, could simply eradicate the bug.
  2. Your immune system can suppress the bug, you could become latently infected, without any signs or symptoms. You won’t have TB disease, but you will have TB infection. You can carry that infection for life, and it can pop up as TB disease decades later.
  3. You will show signs of the disease shortly after infection.

Getting up close

We spoke to Dr Sean Wasserman of the Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, who shared the following TB facts:

  • According to the World Health Organization (WHO) Global report, in 2012 there were an estimated 8.6 million new cases of tuberculosis, with around a quarter of these occurring in South Africa.
  • SA has the highest tuberculosis incidence rate in the world – about 1 000 cases per 100 000 people. Despite the availability of effective first-line drugs with the ability to cure 90 percent of cases, there were up to 100 000 HIV-associated tuberculosis deaths in South Africa in 2012.
  • Tuberculosis is the most important Aids-related infection: HIV leads to higher rates of tuberculosis and makes it more difficult to diagnose. About 75 percent of all people newly diagnosed with tuberculosis in South Africa have HIV.
  • Drug-resistant tuberculosis continues to be an uphill battle. But there are a number of new drugs to treat drug-resistant TB, some of which are in advanced stages of clinical trials, while others are too expensive for use in the public sector.
  • South Africa is one of four countries in the world with the largest concentration of TB sufferers diagnosed with drug-resistant strains of the disease. The others are China, India and Russia.

The good news

Rapid and accurate diagnostic tests have been developed that are able to detect tuberculosis within two hours and also diagnose drug resistance.

The new drugs and diagnostic tests are important developments in tuberculosis treatment and control, which will hopefully be rolled out to as many people as possible in the public sector. “The successful control of the extensively drug resistant tuberculosis (XDR-TB) outbreak in Kwazulu-Natal a few years ago has shown us that limiting spread and controlling tuberculosis infection is possible,” says Dr Wasserman. Tuberculosis is a curable disease, he stresses, and can be prevented by taking anti-tuberculous medicine properly and for the full duration, getting tested early for HIV and seeing a doctor if tuberculosis is suspected. “The symptoms of tuberculosis include cough, fever, night sweats and loss of weight. If any of these are present, especially if an individual is HIV-positive, they should get a tuberculosis test as soon as possible,” cautions Dr Wasserman.

Did you know?

  • The most common type of TB is in the lungs, known as pulmonary TB. Only TB of the lungs or throat can be infectious. TB can affect any part of the body including kidneys, brain or bones. This is called non-pulmonary TB – and is not infectious.
  • In many countries, diagnosis has depended largely on one archaic test for the last 120 years.
  • TB is one of the greatest causes of deaths in women aged 15 to 44, and although it can be cured, it kills thousands of children worldwide annually, according to Doctors Without Borders. 
  • You cannot get TB by sharing cutlery, bedding or clothes.