Tuberculosis (TB) is a serious public health issue in South Africa and is currently a leading cause of death for the nation. In October 2020, a World Health Organization report showed that more people are falling ill with TB in South Africa than previously thought. On the bright side, the country’s treatment success rate even for dangerous drug-resistant forms of the disease has improved.
At Elixi, we believe that you should be able to access good quality medical treatment whenever you need it. Without regular health check-ups TB can often go undiagnosed and we understand how unforeseen medical conditions can turn your world upside down. We have answered the important questions about tuberculosis in South Africa for you below.
What is TB?
Tuberculosis caused by a bacterium known as Mycobacterium tuberculosis. It responds to antibiotics, however, due to its slow growth, it requires treatment for about 6 months. TB is commonly known as a disease in the lungs (Pulmonary TB), but it may also cause disease in any other organ of the body:
- Lymph node TB
- TB of the brain
- TB of the skin
- TB of the bone
Is TB common in South Africa?
South Africa has the 5th highest burden of TB globally. TB is very common and one of the leading causes of death in the country. The joint HIV/TB epidemic affects all socio-economic classes.
The WHO Global Tuberculosis Report 2020 indicates that around 360 000 South Africans fell ill with TB in 2019. This is a 20% increase over the 2019 WHO report that estimated 301 000 people contracted TB in 2018.
There are multiple gaps in South Africa’s healthcare system; difficulty accessing healthcare and TB tests, patients not receiving their TB results or starting treatment, not finishing treatment, and not conducting adequate contact tracing and appropriate further screening and testing. This puts people’s lives at risk.
The signs and symptoms of TB
TB symptoms vary depending where in the body the TB bacteria are growing. It is difficult to diagnose TB from the symptoms, so to diagnose TB it is necessary to do at least one TB test. The general symptoms or signs of active TB include;
- no appetite
- weight loss
- weakness or fatigue
- fever (with a temperature of 38°C or higher)
- sweating at night
How do you get TB?
TB can occur at any age, in any person. It is seen in newborn babies who acquire TB from their ill mother’s placenta; or older children who may acquire it from a caregiver; or adults and pregnant women, in rich and in poor communities, in HIV positive and HIV negative people.
Generally, TB is spread through coughing: the ‘droplets’ of saliva carry the bacteria and may be breathed in by a person nearby. That person may become infected with TB (the TB bacteria is internalised and begins to grow) but if they have a robust immune system, they may never become ill because the immune system may isolate the bacteria.
Many people can carry a dormant infection, with only 5% going on to develop active TB within eighteen months and the same percentage at risk of developing TB later in life.
Is there a TB cure?
TB is curable, but if a person is also HIV positive, it is advised to treat both the TB and the HIV to achieve the best outcome. This means the patient will receive lifelong Antiretroviral treatment and TB treatment for the appropriate length of time.
In 2018, South Africa became the first country in the world to introduce the new anti-TB drug for the first-line treatment of drug-resistant TB. This greatly improved people’s chance of survival and reduced side effects associated with older injectable TB drugs.
How is TB Diagnosed?
Diagnosis is quite complex (particularly for those living with HIV). Since many symptoms are like those of other common diseases, TB can go unnoticed. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. As an Elixi Health member you’ll have access to annual wellness health screenings at your nearest Dischem or Clicks pharmacy that check your overall wellbeing as well as indicators of chronic conditions.
A survey released on 5 February 2021 indicated a “blind spot”, showing positive cases having no symptoms which means there must be a whole rethink of how TB is screened.
What do I do if I think I have TB?
All children receive the BCG vaccine at birth in South Africa. It is a live vaccine that stimulates the baby’s immune system to build antibodies to protect against TB. The vaccine is protective against more severe forms of TB (like TB meningitis and TB lymph nodes) but not considered effective against Pulmonary TB. A person who is infected (but not diseased) or has TB contact may take a 6-month course of Isoniazid (an Anti-TB drug) to prevent TB.
An HIV positive person is more likely to develop severe forms of TB due to their weakened immune system. As this TB is more severe, more widespread, and takes longer for the medications to clear, the treatment course can be up to 2 years long to achieve a full cure.
What TB medication is there?
According to the WHO Global Tuberculosis Report 2020, for multi-drug resistant TB (MDR-TB), South Africa’s treatment success rate is 60% while the global average is 57%. MDR-TB is TB that is resistant to at least two of the most common medicines used to treat TB.
Does Elixi cover TB medication?
The enormous load on the public health system can result in long waits for basic medical care and in some cases, patients simply do not get access to quality treatment. With Elixi medical insurance, you can get access to benefits like unlimited private Network GP visits and acute medicine, but without the expensive cost of private medical care! Elixi Black and Gold Plans offer Chronic Medication for TB with primary care and accidental hospital cover up to R1.1 million.