Just today, all across the world, nearly 4000 people lost their lives to Tuberculosis (TB) and close to 28 000 people have been newly infected. TB is one of the deadliest infectious killers, despite it being preventable and equally curable1. To highlight the plight of this slowly progressing worldwide epidemic, World TB Day is observed on 24 March, the anniversary of the day in 1882 when Dr. Robert Koch discovered the bacterium responsible for TB. This year, the theme for the World TB Day is the ‘The Clock is Ticking’.
The intention is to convey a sense of urgency for global leaders to act on their commitments to combat TB. The plight of the battle against TB has been exacerbated by COVID-19, which has dampened the progress in fighting the curable disease as the healthcare focus has shifted. AIDS Healthcare Foundation (AHF), the largest global AIDS organisation, has consistently highlighted the perils of not addressing this disease – many of its 1.5 million clients are People Living with HIV (PLHIV) who have been impacted by TB. For years, AHF has been advocating for integration of HIV and TB services, such as routinely offering rapid HIV testing to people who have clinical indicators for TB or a positive TB test.
“People living with HIV are more at risk of developing TB, even when they are on ART and we know co-infection of TB and HIV is a risky affair, as each disease speeds up the progress of the other. We screen for, test and diagnose TB along with HIV so that we can offer holistic and effective treatment to our patients. There are many different TB Preventative Therapies (TPT) available, and we would like to encourage everyone to join our nationwide World TB Day events and be screened for TB and tested for HIV” said Dr. Dube, AHF South Africa Country Program Director. A quarter of the world's population is estimated to be infected with latent TB according to The World Health Organisation (WHO). This poses a grave risk to PLHIV, as they are more likely to develop TB after exposure and for the infection to progress into active TB rapidly because of a weakened immune system.
This remains true even for those on ART. Hence the emphasis on vigilant routine TB screening on this group of patients on every visit to health facilities. One powerful and effective way to prevent illness and to save lives is for PLHIV to access TB Preventative Therapy (TPT). It is however important to exclude active TB before offering TPT. TPT alone is inadequate in treating active TB disease and its continued use in these patients is likely to result in the emergence of Drug Resistant TB (DRTB).
Adults and adolescents living with HIV should be screened for TB and those who do not report any symptoms of current cough, fever, weight loss or night sweats are unlikely to have active TB and should be offered preventive treatment, regardless of their ART status. Thus, TPT is offered to candidates who are still feeling well and the medication is prescribed to prevent TB from becoming an active disease.
According to WHO, studies have shown that the protection provided by TPT can last anywhere from 7 to 19 years.(Source: https://apps.who.int/iris/bitstream/handle/10665/331525/9789240002906-eng.pdf ) The Centers for Disease Control and Prevention website states: “TPT reduces the number of patients who die in the 5 years after completing treatment by nearly 40 percent. When paired with ART, TPT can reduce the risk of death for those living with both diseases – by as much as 80 percent”. (Source: https://www.cdc.gov/globalhivtb/who-we-are/features/tbpreventivetherapy.html ) For more information on AHF, visit either www.freeHIVtest.org.za or www.facebook.com/aidshealth.org
EVENTS - FREE AHF’s World TB Day events will be hosted as follows:
WHAT: WORLD STOP TB DAY WITH GAUTENG DEPARTMENT OF HEALTH
TOPIC: Discussions on Stigma, support, treatment and confidentiality
WHEN: Wednesday, 31st March 2021
TIME: 10H00 to 14H00
WHERE: Tshepisong Clinic
1754 Unnamed Rd Soweto, Tshepisong, Soweto, 1754
WHAT: TB HEALTH TALK WITH MICHAEL MKHUNGO
WHEN: Friday, 19th March 2021
TIME: 10H00 to 14H00
WHERE: Ithembalabantu Main Entrance
Ground Floor W Section, 162 Zwemadlala Drive, Umlazi, 4066
WHAT: TB HEALTH TALK with Dr Mtila and EC Department of Health
WHEN: Wednesday, 24th & Thursday, 25th March 2021
TIME: 10H00 – 14H00
WHERE: Macibe Clinic