April 22, 2018


Matseliso Morigihlane


theweekly.coSouth Africa recently joined the rest of the world in celebrating World TB Day. The event is celebrated annually on March 24 but the country celebrated it last Friday, March 31 in Bloemfontein.

The theme for this was: Unite to end TB and HIV- South African Leaders taking Action. The Weekly’s Martin Makoni spoke to the Director for TB Management and Control in the Free State Matseliso Morigihlane on the significance of the day and the situation of the in the province.

Makoni also asked Morigihlane about and the province was doing to address the problem of TB and how ordinary people can contribute to the fight and reduce the prevalence of the disease. Excerpts:

Can you please start by defining what TB is?
TB or Tuberculosis is a disease caused by a bacteria called Mycobacterium tuberculosis. The disease mostly affects the lungs and the TB bacteria is usually spread from one person to another through tiny droplets released into the air through coughing, sneezing or spiting.

A person needs to inhale only a few of these germs to become infected. Besides the lungs, TB can also affect other parts of body like the bones, stomach, kidneys, skin, brain, womb or the spine.

It seems like everyone could be at risk of catching the disease given that it is mostly spread through the air, who exactly would you say is most at risk with TB?
TB can affect anyone because we all have the TB bacteria in our bodies.

The bacteria lies dormant in our bodies until it multiplies to be able to make us sick. The chances of one getting affected by the bacteria are however worsened by poor living conditions such as poor diet, living in congested households with poor ventilation like you find in informal settlements where people mostly live in shacks.

People with a compromised immune system also have a higher risk of catching TB.

How easy is it for one to determine if they have TB or not and what stage should one get worried about their health, in relation to TB?
The diagnosis can only be done at a clinic or if you visit your doctor. They will take your sputum which will be taken to laboratory for some tests to be run.

Some of the key symptoms for TB include coughing continuously for three more than three weeks, unintended weight loss, sweating at night and losing appetite. Other signs may include fatigue, chest pain, or pain with breathing or coughing and fever.

Given that there are different types of TB, will the sputum test still be able to detect that I have TB?
When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

This means different tests have to be done depending on your source of discomfort.

What is situation like in the Free State in terms of the figures?
TB figures in the Free State have been on a gradual decline since 2012, which we find quite encouraging. We recorded about 20 000 cases in 2012 but last year the figure was about 15 000.

This means people are taking care of themselves and are not exposing themselves to danger such as poor hygiene and risky sexual behaviour.

This is important because once your immune system is compromised, your chances of contracting TB become higher.

An in terms of population groups or social settings, where is the disease most prevalent?
The problem is most pronounced in the informal settlements because of the poor living conditions found there. There is lot of congestion and the housing is very poor. The risk of active TB is greater in persons suffering from other conditions that impair the immune system such as HIV and AIDS.

TB mostly affects adults in their most productive years. However, all age groups are at risk. Even someone who is rich and living a more comfortable life can contract TB. It all depends on how you look after yourself and maintain good health.

The Free State hosts this year’s national World TB Day commemoration, how important is this day?
It is a very important day because that’s when we celebrate the discovery of the of Mycobacterium tuberculosis, the bacterium that causes tuberculosis by German physician and scientist Robert Koch on March 24, 1882. It is also an opportunity to raise awareness about the burden of TB worldwide and where we stand in terms of prevention and care efforts.

This year we launched the short regimen for the treatment of Multi-Drug Resistant TB.

Previously, this was treated over a period of about 18-24 months but with the new drug, treatment only lasts for nine months. The celebration also coincided with the country’s launch of the National Strategic Plan on HIV, TB and Sexually Transmitted Infections (STIs) for the period 2017-2022.

If you can please elaborate on that strategic plan, what is the country doing?
It is a plan that encourages everyone in South Africa to take action to end the epidemics of TB, HIV and STIs. The plan emphasises the importance of achieving the 90-90-90 targets.

This means by 2020, 90 percent of the people infected with HIV should be diagnosed, 90 percent of those diagnosed should be on antiretroviral treatment and 90 percent of those on anti-retrovirals should be virally suppressed. Viral suppression is when a person’s viral load or the amount of virus in an HIV-positive person’s blood – is reduced to an undetectable level.

This national plan of action is based on eight strategic goals, how related are they?
Goal tne is to accelerate prevention to reduce new HIV, TB and STI infections. Goal two is to reduce morbidity and mortality by providing HIV, TB and STIs treatment, care and adherence support for all.

Goal three is to reach all key and vulnerable populations with customised and targeted interventions. Goal four is to address the social and structural drivers of HIV, TB and STI infections. Goal five is to ground the response to HIV, TB and STIs in human rights principles and approaches.

Goal six is to promote leadership and shared accountability for a sustainable response to HIV, TB and STIs. Goal seven is to mobilise resources to support the achievement of NSP goals and ensure a sustainable response and the last one seeks to strengthen strategic information to drive progress towards achievement of the goals of the national strategic plan.

This seems quite a daunting task, is this really achievable given the set time frames and what can people do to complement government efforts?
It is not an easy task of course but this is our daily work. The difference now is that it is more structured and there set targets. It can be achieved if we all work together. Cooperation by people is very important.

Some of the things that they can do include, simply ensuring that they are living in a clean environment, having a healthy diet, avoiding risky sexual behaviour, having regular medical check-ups and not dismissing TB as a product of witchcraft. We encourage that when one does not feel well for some time, they should visit a clinic or see a doctor to get checked. We like to get to a point when community is fully aware of the disease and how to prevent it.

What should be the starting point in this fight against TB, what should people always bear in mind?
At all costs, one must maintain a healthy diet and continuously eat well. People should be vigilant and constantly monitor their health. If one starts losing weight, example or experience some kind of discomfort in their bodies, they must see immediately seek medical help.

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