TB: get tested

This ancient disease is posing more of a global health emergency than ever – even though it is curable and cost-effective to treat.

Tuberculosis (TB) is a contagious disease that spreads through the air like a common cold. When infectious people who have TB in their lungs cough, sneeze, laugh, spit or sing, germs are spread through the air where they can be breathed in by other people. Yet, TB is curable and diagnosis and treatment is free.

Today, 24 March, is World TB Day - a time to help South Africans understand and manage this disease.

TB is as old as humans themselves and has even been found in fragments of Egyptian mummies dating from 2400 BC. Even in 460 BC, Hippocrates, the famous Greek physician, identified TB as a widespread and fatal disease. Hundreds of centuries later, TB is still spreading and killing over two million people every year around the world. In fact, TB kills more people than Aids, malaria and tropical diseases combined.

1 in 3 people have TB

TB infection is different to TB disease. More than two billion people – one third of the world’s population – are infected with TB. Fortunately, not all those infected will become sick. In most cases, the germs are sealed off in the body and do not multiply. One in every ten of these people will become sick with active TB in his or her lifetime. If the body's defenses can no longer control the germs, they become active and the person will get TB. This is why people living with HIV are at a much greater risk of developing TB, since they have weakened immune systems. Of approximately 1, 770 000 people who died from TB in 2007 globally, 456 000 of them had HIV. If left untreated, a person with active TB can infect about 10 to 15 people each year.

TB/HIV integration

For this reason, the Department of Health is integrating TB and HIV treatment.

The new ARV treatment guidelines adopted by the DoH, include TB/HIV integration and other evidence based HIV treatment protocols such as using better tolerated tenofovir, decentralisation of service delivery to primary health care, nurse-initiated treatment, providing ARVs to all HIV-infected infants, pregnant women and people with TB with a CD4 count of less than 350.

"It is a matter of one patient with two diseases. There are different meanings of TB/HIV integration, but it is more than treating a patient for HIV and TB under one roof - it is about one clinic, one queue, one folder, one clerk, one nurse and one doctor, for both diseases in one patient," says Dr Gilles van Cutsem, Project Coordinator for Médecins Sans Frontières (MSF) Khayelitsha.

 Here is some more valuable information on TB:

Symptoms:

• A cough which lasts longer than two weeks
• Chest pains
• Tiredness and weakness in the body
• Loss of appetite and weight
• Night sweats, even when it is cold
• Coughing up blood.

People at an increased risk of getting TB:

• Close contacts of TB patients, especially children under 5 years old
• People with diseases like diabetes and HIV/Aids
• People who consume excessive alcohol and drug addicts
• People with poor nutrition
• People suffering from stress
• People living in poorly ventilated and over-crowded rooms

Steps to avoid TB:

• Covering your mouth when coughing or sneezing
• Eating balanced meals consisting of food like meat, fish, eggs, beans, amasi, brown bread, maize meal, vegetables and fruits.
• Alcohol should be avoided because it lowers body resistance, and affects the treatment.
• Smoking causes further damage to the lungs and can also cause heart disease and lung cancer.
• Getting some sunshine, fresh air, exercise and living in a clean environment, including opening windows where possible in the home and workplace to ensure fresh air at all times

In South Africa, the Directly Observed Treatment Short Course (DOTS) is very affective in helping patients to ensure that medicines are taken daily. DOTS does not involve long periods of hospitalisation, instead a person can take treatment at home, work or school. - (Health24, March 2010)

Sources: The Write Agency/MSF/TAC/City of Cape Town Health Department