{"id":4296,"date":"2023-11-20T13:40:22","date_gmt":"2023-11-20T11:40:22","guid":{"rendered":"https:\/\/newmediacreative.co.za\/afrocentric\/?p=4296"},"modified":"2023-11-21T08:47:32","modified_gmt":"2023-11-21T06:47:32","slug":"an-update-to-the-tb-guidelines","status":"publish","type":"post","link":"https:\/\/newmediacreative.co.za\/afrocentric\/archives\/4296","title":{"rendered":"An update to the TB guidelines"},"content":{"rendered":"\n
It\u2019s exciting to note that the Department of Health (DoH) has updated their Tuberculosis (TB) guidelines to be in-line with the World Health Organization (WHO) recommendations, meaning a reduced time on treatment for people with drug-resistant TB. This will go a long way to ensuring adherence to treatment and reducing TB transmission.<\/strong><\/h5>\n\n\n\n

South Africa has one of the highest rates of TB in the world and according to the WHO, is one of the top 30 high TB burden countries worldwide.*1<\/sup> In 2020, there were 328 000 reported active infections.*6<\/sup> and between 2020 and 2022, an average of 55 000 people died of TB per year in South Africa.  <\/p>\n\n\n\n

A major driver of TB infection in South Africa is HIV. In 2022, nearly half of all people infected with TB were HIV-positive. Poor living conditions and late presentation to healthcare facilities also contribute to the high rates of infection.*3<\/sup> TB is unevenly distributed in South Africa, with four provinces (KwaZulu-Natal, Gauteng, Eastern Cape, and Western Cape) carrying more than 70% of the burden, and Mpumalanga as the province with the highest prevalence of drug-resistant TB.*6<\/sup><\/p>\n\n\n\n

What is TB? <\/strong><\/p>\n\n\n\n

TB, caused by the bacteria Mycobacterium Tuberculosis, is a contagious infection that primarily attacks the lungs but can also affect other parts of the body, including the heart, bones, skin, brain, spine, abdomen, and lymph nodes.*1<\/sup><\/p>\n\n\n\n

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How is TB transmitted?<\/strong><\/p>\n\n\n\n

TB is spread from person-to-person through contact with respiratory droplets released into the air when an infected person coughs, sings, talks or sneezes (i.e. droplet transmission). .*1<\/sup><\/p>\n\n\n\n

What are the signs and symptoms of TB?<\/strong><\/p>\n\n\n\n

The symptoms of pulmonary TB generally include persistent coughing, fatigue, fever, night sweats, chills, weight loss, and chest pain. Symptoms for infection located in other parts of the body may vary depending on location.*1<\/sup><\/p>\n\n\n\n

How is TB diagnosed?<\/strong><\/p>\n\n\n\n

In South Africa, TB is primarily diagnosed through laboratory testing of sputum and other extra-pulmonary \ufb02uids to look for the bacteria. A chest x-ray is also common and a skin test<\/p>\n\n\n\n

(Mantoux test) can be done in children. There is no single test that can be used to test for TB in all circumstances.<\/p>\n\n\n\n

How can TB be prevented?<\/strong><\/p>\n\n\n\n

TB is curable and preventable. Stopping transmission through early identi\ufb01cation of people with active TB and starting them on treatment is key to prevention. Those infected with TB should also wear a mask covering the nose and mouth to reduce droplet spread.*1<\/sup><\/p>\n\n\n\n

People who are exposed to someone with TB can be put on TB prevention treatment (TPT) to stop the onset of the disease. TPT is safe for all age groups and should be offered to all people (regardless of age and HIV status) after signi\ufb01cant TB exposure and those who are immunocompromised (regardless of known exposure), after TB disease has been ruled out. <\/p>\n\n\n\n

In South Africa, the current TPT options include: <\/p>\n\n\n\n

\u2022          3HP: three months of isoniazid and rifapentine given once weekly.<\/p>\n\n\n\n

\u2022          3RH: three months of daily rifampicin and isoniazid.<\/p>\n\n\n\n

\u2022          6H: six months of daily isoniazid.<\/p>\n\n\n\n

\u2022          12H: 12 months of daily isoniazid.<\/p>\n\n\n\n

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Is there a TB vaccination<\/strong>?<\/p>\n\n\n\n

The Bacille Calmette-Guerin (BCG) vaccine is currently the only available TB vaccine and has been widely used for more than 100 years. Vaccination with BCG was made mandatory in South Africa in the 1970s and to date is given as an injection to newborns as it does not offer protection to adolescents and adults. South Africa is currently participating in new TB vaccine trials in newborns and adults (called M72). <\/p>\n\n\n\n

How is TB treated?<\/strong><\/p>\n\n\n\n

Once a positive diagnosis is made, TB treatment with a combination of oral drugs can be started. This is typically a 6-month course of multi-drug regimens containing rifampicin, isoniazid, pyrazinamide and\/or ethambutol.<\/p>\n\n\n\n

TB is no longer considered contagious two weeks after initiation of TB treatment. It is important that treatment is strictly adhered to, and all courses are completed to prevent drug resistance. Drug resistance happens when the bacteria that causes TB infection develops resistance to treatment. <\/p>\n\n\n\n

There are different types of drug resistance:<\/p>\n\n\n\n