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TB in South Africa: Q&A

Tuberculosis or TB is an infectious bacterial disease which spreads through the air. Although it is preventable, curable and treatment is free, it is a major health problem for South African communities and we all have a role to play in ending it. On World TB Day, 24 March, let’s raise awareness, encourage testing and support treatment to help end TB.

What is the current situation of TB in South Africa?

South Africa is still dealing with a very high burden of tuberculosis (TB). In 2022 there were over 280 000 new cases of TB reported and it remains our leading cause of natural death. This means that efforts are ongoing to tackle and manage the impact of TB on the people of South Africa.

What contributes to the high prevalence of TB in South Africa? 

A number of factors contribute to South Africa’s TB burden:

  • If someone is living with HIV, their immune system becomes weaker, making it easier for them to contract or develop TB disease. South Africa has the largest number of people living with HIV in the world so HIV co-infection is one of the biggest contributors.
  • Due to stigma, embarrassment and lack of awareness, people often take a long time to seek help when they experience TB symptoms. During this period, TB spreads as they are not undergoing treatment.
  • Crowded living conditions, uneven access to healthcare services, poverty, and lack of resources also contribute to the problem. Some people lack money for transportation to reach healthcare facilities and for food needed before taking the medication.
  • Stigma is a significant factor causing people to avoid TB testing due to its association with HIV and because of fear of judgment.

Is there treatment for TB?

Unlike HIV, TB is curable. TB treatment is safe and completely free at any public health facility. It is important to start treatment as soon as possible and to finish the whole treatment. People need to stay on these medicines for at least 6 months and sometimes longer, depending on the type of TB they have.

How do you prevent TB?

TB is preventable through simple things like not sharing smoking devices, covering your cough, avoiding overcrowded areas and opening windows in rooms and on public transport. Pills to prevent TB disease are available for people who are living with HIV and those who have been in contact with someone who has TB.

What is drug resistant TB ?

Drug resistant forms of TB have developed because people didn’t take their medicine properly. These are called multi- and extremely-drug resistant TB (MDR- and XDR-TB) and they are easier to catch and much harder to treat and cure. You can get drug resistant TB even if you have never had TB before. These forms of TB need treatment for longer, anywhere from 6 months to up to 2 years. 

How does TB connect with other health issues, especially HIV? 

HIV makes the immune system weaker, so people who are HIV positive are more likely to get TB. The good news is that there is a team effort to combine TB and HIV services to make sure that patients get complete care for both infections, and HIV positive people can get medicine to prevent TB. Being on anti-retroviral treatment (ART) makes people living with HIV less likely to get sick and die from TB. 

What is NACOSA doing to fight and stop TB? 

All of NACOSA’s programmes screen and also test people for TB disease. Our programmes also link people at high-risk of developing TB disease to preventive and other services. NACOSA’s Community Strengthening System programme works with community organisations like Zazele Foundation, working directly in communities to combat TB. They offer healthcare services including screening for TB, teach patients to follow their prescribed treatment plan and educate the community about the illness.  

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