Tuberculosis (TB) has been present in humans since antiquity. It has been found in the spines of Egyptian mummies dating from 3000 to 2400 BC and in prehistoric human skeletal remains dating from 7000 BC. Today, tuberculosis is found throughout the world, but about 80% of the population in mainly Asian and African countries test positive for TB, while only 5 to 10% of the people living in the USA test positive.

According to the World Health Organisation (WHO), South Africa has the world’s highest TB incidence rate at 948 infections for every 100,000 people. Left untreated, each person with active TB disease will infect on average between 10 and 15 people every year.

People infected with TB will not necessarily become sick with the disease. The TB bacteria can lie dormant for years, protected by a thick waxy coat. When someone’s immune system is weakened, the chances of becoming sick are greater.

In the South African context, this has serious consequences. Approximately 5.7 million South Africans are HIV-infected, meaning that their immune systems are weakened. It is estimated that 1.8 million of these people living with HIV or Aids will get TB. In fact, by 2005 the number of TB cases has increased by 300% since 1989. TB is the most common opportunistic infection and the leading cause of death among people living with HIV or Aids.

 

How infection takes place

TB is an infectious bacterial disease caused by a bacterium, Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.

In healthy people, infection often causes no symptoms, since the person’s immune system acts to “wall off” the bacteria.

 

Symptoms

The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats.

 

Way forward

Tuberculosis is treatable with a six-month course of antibiotics. However, the course must be completed as prescribed or the bacterium becomes resistant, which makes is very difficult and sometimes impossible to treat the disease.

There is a global plan in place to deal with TB, namely the The Global Plan to Stop TB, 2006–2015. This plan together with the Millennium Development Goal (MDG) 6, Target 8 aims to “Halt and begin to reverse the incidence of TB by 2015”.

Other targets are to:

  • Targets linked to the MDGs and endorsed by the Stop TB Partnership
  • Detect at least 70% of new sputum smear-positive TB cases and cure at least 85% of these cases by 2005
  • Reduce TB prevalence and death rates by 50% relative to 1990 by 2015
  • Eliminate TB as a public health problem (1 case per million population) by 2050

Currently someone in the world is newly infected with TB bacilli every second. The South African government recognises that TB is preventable and curable, yet people still die from this disease. To fight TB, the government has formulated this pledge through which South Africans can combine their efforts and stand together to help eradicate this disease:

  • I will go for an examination if I cough for longer than two weeks
  • I will advise anyone who coughs for more than two weeks to go for an examination
  • I will take my treatment until the end if I am diagnosed with TB
  • I will help TB patients take their medication everyday
  • I will ensure that my action does not stigmatise TB patients.

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