Tuberculosis (TB) remains the leading cause of death in South Africa. The Free State has seen a decline in the number of drug-susceptible TB (DS-TB) patients registered between 2017 and 2021. This decline ranged from 8 448, 7 919, 8 743, 6 256 to 6 608 over a period of five years.
The MEC for Health, Mathabo Leeto, revealed these findings while the province marked World Tuberculosis Day on Thursday (13/04) at the Mokwallo Staduim in Vredefort. She said the province aims to diagnose at least 29 000 people per annum to curb the TB scourge, with the country’s sharp post-Covid-19 pandemic increase.
“The 90-90-90 strategy was implemented with the aim of finding these missing TB cases. This strategy looks at improving TB screening to above 90%, starting with 90% of those who are confirmed to have TB, and retaining 90% of them until end of treatment.
“The province is failing to keep patients in care until the end of their treatment. This has been demonstrated with a high loss to follow-up exams: 790, 822, 1 008, 1 211, and 947 reported over five years, 2016 to 2020,” said Leeto, further revealing that TB deaths in the Free State ranged between 1 400 and 880 for the period in question.
“In alignment to the national theme of ‘Yes! You and I can end TB’, the province takes cognisance that encouraging individual action to contribute to the national effort against TB is important.
“The improved success of treatment completion came about with the introduction of the shortened regimen introduced in 2017. It now involves nine months instead of 24 months of care,” said Leeto, further calling on individuals and representatives of various sectors to become TB activists.
Burden remains
A recent report by the World Health Organization (WHO) places South Africa among the 30 countries with a high TB burden, which in 2020 collectively contributed to 86% of the estimated cases worldwide. According to the global health agency’s Global TB Report, close to 304 000 South Africans developed TB in 2021, increasing the country’s incidence rate to 513 per 100 000.
It also revealed that South Africa has the highest burden of TB, HIV, and multi-drug resistant TB (MDR-TB). Furthermore, it revealed that in 2019 a total of 58 000 people died of TB in South Africa.
The country’s worrying TB situation was reiterated on the back of World TB Day, observed on 24 March. The day aims at raising awareness, educating the public, and encouraging the government to strengthen the fight in curbing the spread of the disease. The WHO states that the high death rate of TB is due to misunderstanding of the disease, adding that the impact of TB is not often discussed.
Action taken
Becton Dickinson (BD), a leading global medical technology and diagnostics provider, was rolled out with the chief objective to intensify awareness and education around TB.
Ian Wakefield, general manager of BD Africa, explained the goal.
“It is essential for everyone to be aware of this disease, and how they can prevent and screen for it. BD research develops medical technologies that support health systems and health workers, as well as benefit their patients. We are proud to participate in this vital initiative. It is a giant step towards making quality healthcare accessible to South Africans who need it most,” said Wakefield.
According to findings by the WHO, numerous factors drive South Africa’s TB epidemic. The country’s low socio-economic status and a high HIV co-infection has been highlighted as among the main issues. According to the first national TB prevalence survey in 2018, delayed health-seeking behaviour among individuals with TB and the high burden of undiagnosed diseases in communities also drive this epidemic.
Awareness drives diagnoses
While South Africa is commended for effective TB treatments that are available and show considerable progress in fighting the disease, the government has been encouraged to strengthen its efforts.
“We are all aware of the different challenges health systems are facing. That negatively impacts on health outcomes, including the detection of TB cases and their effective treatment.
“In 2023, we can approach this major contributor to South Africa’s burden of disease with new energy, and step-up awareness and TB services to all communities,” said Wakefield.
Members of the public are encouraged to do TB testing and screening.
The following are TB symptoms: general feelings of sickness or weakness, unexplained weight loss, fever, night sweats, incessant coughing or coughing up blood, and chest pain.
The National Department of Health has launched a self-screening tool for TB to use for free, anytime and anywhere. WhatsApp ‘TB’ to 060-012-3456 or dial *134*83285# and follow the instructions.
