Is TB the leading cause of death in SA?

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In South Africa, TB accounted for more than 33 000 deaths in 2015. What is being done to curb the high infection rate? …

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TB: Leave no one behind

More needs to be done to curb the high rate of infection of tuberculosis (TB), multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR TB) in South Africa.

This is the view of the AIDS Healthcare Foundation (AHF), the largest international non-profit HIV/AIDS healthcare provider, as the world gears up for World TB Day on Friday, 24 March.

It is the second year of a global two-year ‘Unite to End TB: Leave no-one behind’ campaign for World TB Day.

The TB killing fields

TB accounted for more than 33 000 deaths in 2015 – according to Statistics South Africa (Stats SA) – and averaged over 7% of all deaths in the country from 2013 to 2015.

“These are alarming numbers that present a bleak picture of our fight against TB,” says Larissa Klazinga, Regional Policy and Advocacy Manager for AHF Southern Africa. “The statistics clearly indicate that we are not winning the war against TB and this is especially devastating when TB & HIV co-infection are considered.”

What is TB and HIV co-infection?

TB and HIV co-infection is when a patient is HIV+ and has either latent or active TB.

Worldwide it is estimated that in 2015 alone, 400 000 people who had both TB and HIV died in addition to the estimated 1,8 million who died from TB. Furthermore, figures show that approximately 10,4 million new cases of TB occur worldwide annually – 11% of these were also people living with HIV.

“According to Stats SA, TB is the leading cause of death in South Africa,” Klazinga adds. “Untreated, incorrectly treated, or the skipping of TB medication can lead to MDR-TB and XDR-TB, which can accelerate the disease’s deadly effect in people with HIV.”

What is multi-drug resistant tuberculosis (MDR-TB)?

MDR-TB is a virulent form of TB infection caused by bacteria resistant to treatment from at least two of the most powerful first-line anti-TB medications.

This strain caused an estimated 480 000 new TB cases and 250 000 deaths in 2015 and accounts for 3,3% of all TB cases worldwide. Most MDR-TB cases occur in South America, Southern Africa, India, China and Russia.

Most MDR-TB cases occur in South America, Southern Africa, India, China and Russia.

“The mismanagement of TB treatment is the primary cause of TB developing into MDR,” Klazinga explains. “Social issues are very often the cause of treatment failure, for instance, the patient not having access to adequate nutrition or transport to clinics.”

“Social issues are very often the cause of treatment failure, for instance, the patient not having access to adequate nutrition or transport to clinics.”

“We tend to forget that some people living in rural and sub-rural areas may have to catch one, two or even three taxis to get to a clinic or hospital, having to pay anywhere between R40 and R80 for a one-way trip and leading to having to weigh up the cost of medication against putting bread on the table.”

The rise of extensively drug-resistant TB (XDR TB)

Since 2017 the number of countries with reported cases of XDR-TB has risen to 100, from the initial 49 nations in 2008.

XDR-TB was first widely publicised in 2006 following an outbreak in the rural hospital of Tugela Ferry. Fifty-three patients were found to have XDR-TB, of whom 52 died within 16 days of the sputum specimen collection.

“What is needed is more resources and detailed education on TB, MDR-TB, XDR-TB and the importance of continuing medication once a patient has begun their treatment,” Klazinga says.

“This needs to be done through community engagement, primary, high school and tertiary institutions along with continual follow-ups on patients, who are on medication, as this is the only way that we may reduce the amount of MDR and XDR-TB cases.”

How to protect yourself from TB

Anyone can contract TB, but poor nutrition, cramped living conditions and lack of access to healthcare makes people more vulnerable to infection.

To reduce your risk of contracting TB, follow these recommendations:

  • Avoid exposing yourself to people with active TB. If this is unavoidable, take protective measurements such as wearing a face mask
  • When travelling in public transportation, open the windows so fresh air can flow in
  • Ensure good ventilation at home and at work by opening windows. TB spreads is closed rooms.
  • Lead a healthy lifestyle which includes walking or exercising in the open air every day, and eating a well-balanced diet of fruit, vegetables, whole grains and legumes, and some lean protein. It is best to avoid smoking and drinking alcohol
  • Ask your clinic for a Bacille Calmette-Guerin (BCG) vaccination if possible

Source: AIDS Healthcare Foundation (AHF)

For more information on AHF, visit www.aidshealth.org 

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