Tuberculosis (TB) is one of the major causes of death in South Africa, killing thousands every year, according to surveys and experts.
“South Africa has the eighth highest TB incidence globally at a rate of 537 per 100,000 population per year,” Jody Boffa, an epidemiologist at the University of KwaZulu-Natal, told Anadolu Agency. “It is one of the 16 countries that account for 93% of the global TB burden.”
Last year, Statistics South Africa (Stats SA) released a report saying that TB topped the leading causes of death in the country in 2018.
Stats SA processed 454,014 deaths that occurred and TB-related deaths stood at 6.0%, followed by diabetes, cerebrovascular diseases, other forms of heart disease and human immunodeficiency virus (HIV), among others.
The estimated number of TB cases in South Africa in 2018 was 301,000, while the number of deaths were 63,000, according to the National Institute of Communicable Diseases (NICD).
In 2019, an estimated 360,000 South Africans became sick with TB and 58,000 died from the disease.
Stats SA’s June 2021 report found TB remained the leading cause of death in the three years from 2016 – 2018.
HIV major driver of active TB
Boffa said a recent prevalence study found that eThekwini in KwaZulu-Natal province has the highest rate of TB in the country at 737 per 100,000 population.
She said HIV is a major driver of active TB since immune suppression contributes to the activation of a latent TB infection and “70% of the TB diagnosed in SA (South Africa) is among people living with HIV,” she said.
People with TB often face stigmatization in South African communities where people believe those diagnosed with the disease are automatically HIV positive.
Boffa said the close association between TB and HIV makes it difficult to counter the perception that TB only affects people with HIV.
She said adherence support workers on the Connect TB project are clear with all patients diagnosed with TB that all they did to get TB was breathe.
Connect TB is a project in KwaZulu-Natal province that connects people with tuberculosis symptoms to see private physicians in the eThekwini district to get free testing through the National Health Laboratory Service (NHLS). The project aims to reduce diagnostic and treatment delays in the private sector.
South Africa remains the global epicenter of HIV/AIDS infections with 7.7 million infected. It is also facing the highest number of coronavirus infections on the continent with 3.48 million cases and 91,451 fatalities.
According to the US Centers for Disease Control and Prevention (CDC), TB bacteria are spread through the air from one person to another.
“The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks or sings. People nearby may breathe in these bacteria and become infected,” the CDC said on its website.
It added that when someone breathes in TB bacteria, it can settle in the lungs and begin to grow. From there, it can move through the blood to other parts of the body such as the kidneys, spine and brain.
TB disease in the lungs or throat can be infectious. This means the bacteria can be spread to others. TB in other parts of the body, such as the kidneys or spine, is usually not infectious.
People with TB are most likely to spread it to those they spend time with every day. This includes family members, friends, coworkers or schoolmates.
Untreated TB is deadly
Buyisile Chibi, project manager for the Connect TB project at the University of KwaZulu-Natal, told Anadolu Agency that untreated TB is dangerous.
“If left untreated, about 50% of people with TB will die, although this rate is higher among those who are immunosuppressed,” she said.
Chibi further said that among those who survive, many would be affected by chronic lung issues for the rest of their lives.
“In addition to this, people who are not on treatment for pulmonary TB (TB of the lungs) would continue to transmit to those around them, further impacting households and communities.”
South Africa also faces the challenge of multidrug-resistant TB (MDR-TB), like elsewhere in the world, according to Chibi.
The country has been working hard to decentralize treatment for drug-resistant TB, making treatment more accessible.