Updated 15 March 2016

Capetonians using cough syrup for TB

Many people try to treat Tuberculosis with cough syrup or antibiotics, according to the City of Cape Town.

There is no culture of cough hygiene in South Africa and alarmingly many people try to treat tuberculosis (TB) with cough syrup or antibiotics

This is according to the City of Cape Town who have urged residents to get tested for TB in the run-up to World TB Day on 24 March 2016.

TB is an infectious bacterial disease that is caused by a germ that most commonly attacks and damages the lungs.

Close contact with someone who has TB symptoms increases the risk of infection. However, while a skin test may come back positive, not everyone who is infected will develop TB. The difficulty is that it is impossible to predict how many of those with positive skin tests will translate into TB cases later.

Read: TB deaths in SA are disgraceful, says Desmond Tutu

TB claims the lives of about 1.5 million people every year worldwide.

However, City Health has recorded a steady decline in the number of people starting TB treatment in the last five years.

In 2015, 23 815 patients started treatment, of which 1 539 were children four years and younger. Of these, 45% of patients were co-infected with HIV. A total of 1 021 multidrug-resistant (MDR) patients were diagnosed and commenced treatment.

The turnaround time between diagnosis and treatment has been shortened dramatically; HIV tests have become routine for all TB patients; and dual-infected patients will also be started on antiretroviral (ARV) treatment if they are not already on ARVs.

"While our caseload has dropped, these are only the cases we are aware of," said the City’s Mayoral Committee Member for Health, Councillor Siyabulela Mamkeli.

Read: Why you need fresh air when using public transport

"Many people develop symptoms of TB but leave it unchecked or try to treat it with cough syrup or antibiotics. We need people to start thinking TB first and get tested, if only to eliminate it as a possibility. Let’s rather be safe than sorry because the longer TB goes undiagnosed, the more those around you are exposed and at risk of developing disease," said Mamkeli.

Currently, the BCG vaccine prevents very young, susceptible children from developing complicated or severe TB disease, but it does not prevent TB.

Caregivers can take children under the age of five to the City’s clinics for a course of prophylactics if they have been exposed to a person with TB. The prophylactics can also be used by HIV-positive persons in the same situation.

Mamkeli noted that although significant strides have been made in recent years and this has given reason for some optimism, there remain a number of challenges.

5 obstacles facing City Health and its partners in the treatment of TB include:

• There is no culture of cough hygiene in South Africa
• Too many cases go undiagnosed or are diagnosed at an advanced stage
• Some patients are diagnosed, but don’t report for treatment and cannot be traced because they provide false addresses and contact details
• Drug-resistant TB treatment completion rates are problematic because patients have to be booked off work until sputum results are negative; they have to be at the clinic every day for treatment; and the drugs have severe side effects – which may be a contributing reason for patients to default on their treatment
• Poor socio-economic conditions can be directly associated with a higher burden of TB in certain areas in the city

"Ideally we need a vaccine to prevent those breathing in the germs from developing TB, but currently no such vaccine exists. So we have to work with what we have which is education, awareness and regular TB tests."

Read: Is TB spinning out of control in South Africa?

Members of the public are encouraged to familiarise themselves with the symptoms of TB. These include:

• Persistent coughing with bloody mucus
• Fatigue
• Weight loss, slight fever, night sweats
• Pain in the chest

"We encourage residents to adopt safer infection control practices, including getting screened, tested and treated for TB," added Mamkeli.

Exercise, adequate sleep and rest, a balanced diet, limiting alcohol consumption, and quitting smoking are some of the ways to help reduce the spread of TB, according to Allison Vienings, executive director of the Self-Medication Manufacturers Association of South Africa (SMASA).

In an article published on Health24, Vienings listed five simple lifestyle changes to boost the immune system and help fight off tuberculosis bacteria:

1. Eat a healthy, balanced diet with plenty of fruit, vegetables, whole grains, and lean meat. Avoid fatty, sugary and processed foods.
2. Exercise often, at least 3 to 4 times a week. Try to incorporate some good cardiovascular exercise into your workouts, such as running, swimming or rowing.
3. Cut down on alcohol consumption and avoid smoking or taking drugs.
4. Get plenty of good quality sleep, ideally between 7 and 8 hours a night.
5. Maintain good personal hygiene and try to spend as much time as possible outdoors, in the fresh air.

Also read:

A parent's guide to coughs

15 Facts you need to know now about Tuberculosis

6 frequently asked questions about cough medicine for kids


Ask the Expert

Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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