The Covid-19 pandemic has had a devastating impact on TB deaths in South Africa. Here is more information about how the government plans to get the TB programme back on track and how technology is being utilized in the fight against the illness.  Also, what to look out for to protect yourself and how to identify possible symptoms to get help in time.

Covid-19 worsens South Africa’s TB burden

TB deaths have increased globally for the first time in over a decade. This is according to the World Health Organisation’s Global TB Report 2021, released in October. The increase in deaths is due to ‘reduced access to TB diagnosis and treatment in the face of the Covid-19 pandemic’, the report found. The situation is no different in South Africa. In December, Health Minister Joe Phaahla said Covid-19 had side-lined the fight against TB, as well as HIV and Aids. This was because all resources went to combatting Covid, and testing and treatment was disrupted by lockdowns.

Dr Harry Moultrie, senior medical epidemiologist at the National Institute for Communicable Diseases’ Centre for TB, says testing dropped by 32% between March and October 2020.

Getting TB programme going again

Foster Mohale, spokesperson for the National Department of Health, says a TB recovery plan is being drafted.

He says the Incident Management Team (IMT) established as part of government’s Covid response, developed a plan to preserve routine medical services during the second and all subsequent waves.

He says the National TB Programme has also put in place a catch-up plan in support of the IMT plan, and developed in conjunction with provinces. These plans are still being implemented, he adds.

However, he says that the decreases in testing and treatment rates were less severe in the second, third and fourth waves. Mohale says a new, shorter drug regimen is in its pilot phase of being rolled out. Isoniazid-rifapentine (3HP) is taken once weekly, for three months.

What is TB?

TB is a bacterial infection. It spreads through the lymph nodes and bloodstream to any organ in the body, but is usually found in the lungs.

How is TB spread?

TB is highly infectious. It spreads through the air when a person with TB coughs, sneezes or even speaks to another person.

What happens if you are infected?

TB progresses from latent TB infection (when a person has no symptoms) into the disease TB. People with latent TB don’t feel sick immediately, because their bodies can fight the bacteria to stop them from growing. Only once the TB bacteria become active in your body, will your immune system begin to weaken.

What are the symptoms?

The most common symptom of TB is a persistent cough that lasts more than two weeks. Other symptoms include:

• Discoloured or bloody mucus
• Pain in the chest when breathing or coughing
• Unexplained weight loss and loss of appetite.
• Night sweats.
• General feeling of illness or fever for more than two weeks.

Anyone can get TB

This is not a disease that affects only poorer communities, which is why it is  important to get tested if you have TB symptoms. Clinics offer free testing.

Do not spread TB

• Cover your mouth with a tissue or toilet paper when you cough or sneeze, then throw the tissue paper into the bin.
• Turn your head away from people when coughing or sneezing.
• If you do not have anything with which to cover your nose or mouth, cough or sneeze into your elbow.
• Use a mask when you have a cold.
• Wash your hands regularly.
• Open windows and let sunlight come through your house.
• Exercise and live a healthy lifestyle.
• Eat enough healthy food.
• Stop smoking.
• Avoid alcohol.

How bad is TB in  South Africa?

According to Statistics SA, TB was responsible for the most deaths in South Africa in 2018 (454 014 deaths).

As a result of Covid-19 disruptions, pre-2020 data gives the most accurate picture of TB in South Africa. The First National TB Prevalence Survey (South Africa 2018), released early in 2021, showed that South Africa is one of the 30 high-burden TB countries.

The report found that the country’s TB epidemic is driven by a number of factors, including low socio-economic status, high HIV co-infection burden, and delays in seeking treatment.

South Africa’s current incidence of TB is 554 per

100 000 people, according to the Department of Health.

TB health check app launched

A self-screening app was launched in 2021. It enables people to screen themselves for TB. If they are at risk, the app will prompt users to get tested.

The assessment is done via WhatsApp. Simply send ‘TB’ to 0600 123 456 and follow the prompts.

The Department of Health says the uptake was initially slow, but more than 40 000 people are now enrolled on the system.

Sticking to your  treatment is vital

The quicker TB is diagnosed and treated, the better the outcome.

Mohale says when infected people take their treatment as prescribed – and finish the course, the better their chances of being cured.

“When treatment is interrupted, TB resistance may develop. This is bad news, because the patient may then not respond well to treatment.”

He says even if you feel better, you must continue with your medication until you are told to stop. Clinics offer free TB treatment.

Get help

While there is not a dedicated TB helpline in South Africa, the multi-purpose National Aids  Helpline (0800 012 322) handles  TB queries too.