World TB Day

Tuberculosis (TB) remains an epidemic in many parts of the world. Each year on 24 March, we commemorate World TB Day to raise awareness of the disease and increase efforts to end the global TB epidemic.

Since the outbreak of COVID-19, the number of TB deaths in Africa has soared for the first time in more than a decade because of the disruption to health services due to the pandemic. Countries were compelled to reallocate resources and healthcare workers to fight the pandemic, with the result that access to TB diagnoses, treatments and other key health services was restricted.

TB is now the world’s second biggest infectious disease killer, after COVID-19. South Africa has the fifth highest burden of TB in the world, and this condition is one of the leading causes of deaths in the country.

What is TB?

TB is an airborne disease caused by the bacterium Mycobacterium tuberculosis. While it is widely accepted that TB spreads when infected persons expel bacteria into the air by coughing, a recent study by the University of Cape Town shows that regular breathing may be a bigger contributor to the spreading of the illness. The bacteria can survive in the air for up to six hours and can be carried by air currents throughout a room or building.

The TB bacteria usually infect a person’s lungs, but can also attack other parts of their body such as the spine, kidneys or brain. A TB skin test or blood test can be used to diagnose the condition.

The three stages of TB

Most people who are exposed to the bacteria don’t experience symptoms right away. The infection develops in three stages, namely exposure, latent infection and active disease:

1. Exposure. This is when someone is exposed to a person who has TB. At this stage, there are no symptoms of the disease, a TB skin test is negative and the person has a normal chest X-ray.
2. Latent infection. This is when a person is infected with TB but has no symptoms of the disease, usually because the infected person’s immune system “walls off” the TB organisms and the TB therefore remains inactive throughout his or her life. At this stage, the person has a positive skin test but a normal chest X-ray. They are also not contagious. If the person is treated at this stage, active TB can usually be prevented.
3. Active TB. Active TB may develop if latent infection is not treated effectively. Reactivation of TB may occur if the person’s immune system becomes weakened and is no longer able to contain the latent bacteria. The bacteria then effectively “overwhelm” the immune system’s ability to fight the disease, making the person sick with TB. The greatest risk for developing reactivation TB disease occurs within two years after the person has been infected. It can however also occur at any time in ageing people or people with a weakened immune system, HIV, diabetes, malnutrition, or those who take medication that weaken the immune system (e.g. for rheumatoid arthritis, steroids, or cancer chemotherapy).

TB infection in the blood, kidneys or membranes around the brain and spinal cord is the most serious. If not treated properly, TB can be fatal.

Tuberculosis versus COVID-19

TB and COVID-19 are both infectious respiratory diseases. Both diseases attack mainly the lungs and have similar symptoms, including cough, fever and difficulty breathing. Both diseases are also spread through close physical contact.

However, TB is a bacterial infection while COVID-19 is viral. TB also has a longer incubation period with a slower onset of disease.

TB symptoms and treatment

Symptoms of TB include a cough lasting for three or more weeks, coughing up blood or mucus, chest pain, fatigue, fever, chills, night sweats and weight loss. Patients with TB normally require a six-month treatment regimen involving multiple antibiotics. After about two weeks, a person who complies with the treatment will no longer be infectious.

How can you prevent TB?

• Get vaccinated. All children in South Africa receive the bacille Calmette-Guérin (BCG) vaccine at birth. This is a live vaccine which stimulates the baby’s immune system to build antibodies to protect against TB.
• Ventilate environments. Since TB is an airborne infection and TB bacteria can remain suspended in the air for several hours, it’s important to ensure that your environment is properly ventilated. Bacteria can live for longer in damp rooms with no fresh air.
• Practise good hygiene. Covering the nose and mouth when coughing and sneezing reduces the spread of TB bacteria.
• Get enough sunlight. TB bacteria cannot thrive in sunlight. Studies have shown that direct UVC light kills M. tuberculosis bacteria by damaging their DNA so that they cannot infect people, grow or divide.

Medihelp’s benefits for TB

Medihelp Medical Aid offers protection against disease by covering standard immunisation in full for children younger than seven years on the majority of Medihelp’s medical aid plans, while varying insured day-to-day and solid core benefits provide cover for the diagnosis, treatment and care costs for tuberculosis, which qualifies for prescribed minimum benefits. Click here to read more.

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