Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable. Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.
Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to the 2 most powerful, first-line anti-TB drugs.
Extensively drug-resistant TB (XDR-TB) is a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options.
How it is spread
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.About one-quarter of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease. People infected with TB bacteria have a 5–15% lifetime risk of falling ill with TB. However, persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill.
Tuberculosis (TB) is one of the top 10 causes of death worldwide.
In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease (including 0.4 million among people with HIV). Over 95% of TB deaths occur in low- and middle-income countries.
Seven countries account for 64% of the total, with India leading the count, followed by Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa.
TB is a leading killer of HIV-positive people: in 2016, 40% of HIV deaths were due to TB.
TB in South-Africa
TB was first identified in South Africa as long ago as the seventeenth century. Between 1895 and 1910 TB began to spread so quickly that it became of epidemic proportions. In 1919 TB was made a notifiable disease throughout the entire country.
South Africa is one of the countries with the highest burden of TB, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.About 0.8% of the population of about 54 million develop active TB disease each year.
The number of TB patients in the province has decreased over the past years, dropping to 43 294 in 2015/16 treated at 451 Clinics or treatments sites. In the Eden District, the number of TB patients has remained constant over the last three years, reaching 4909 in 2016 treated at 90 Clinics or treatment sites.
By 2016 the very significant achievements in respect of HIV and TB were said by the South African government (National Strategic Plan 2017-2022) to include:
- Deaths due to HIV had dropped from 681,434 in 2006 to an estimated 150,375 in 2016.
- 3.7 million people were taking antiretroviral treatment for HIV, but this was only 53% of those eligible for treatment
- Deaths due to TB had dropped from 69,916 in 2009 to 37,878 in 2015.
- The number of new HIV and TB infections had fallen, and a higher proportion of people living with these infections had been diagnosed and treated.
- In 2016 an estimated 270,000 people became newly infected with HIV, and the 2015 estimate of new TB cases was 450,000
The role of Eden District Municipality
- Environmental Health is a District municipal function.
- Environmental Health is concerned with the health and well-being of people by addressing elements of health and safety and assessing various physical, chemical and biological factors in the surrounding environment for their potential negative effects.
- TB is a notifiable medical condition in terms of The National Health Act 61 of 2003: Regulations relating to the surveillance and the control of notifiable medical conditions
- The World tuberculosis day (24 May) is designed to build public awareness about the global epidemic of TB and efforts to eliminate the disease.
- The Surveillance and Prevention of communicable Diseases forms part of the Scope of Practice for Environmental Health Services.
In terms of this scope of Practice the Eden Environmental Health Practitioners are conducting:
- Health and hygiene promotion aimed at prevention of environmentally induced diseases and related communicable diseases, such as TB.
- Collection analyses and dissemination of epidemiological data and information on TB.
- Use of Participatory Hygiene and Sanitation Training (PHAST) approaches for effective control measures at Community Level.
Epidemiological surveillances of Tuberculosis .
- Develop environmental health measures with protocols reference to epidemics, emergencies, diseases and migrations of population.