Rédaction Africa Links 24 with Dr Janet Giddy for Spotlight
Published on 2024-03-18 13:54:01
For many decades, I have served as a primary care doctor in the South African public sector, and during this time, I have encountered multiple women expressing similar concerns about tuberculosis (TB). They often approach me with worries about their domestic workers being diagnosed with TB and fear that their family members may also be at risk of contracting the disease. This fear is understandable given the high prevalence of TB in South Africa, where approximately 300,000 people develop the disease each year, leading to around 54,000 deaths annually.
In the past, my response to these concerns would usually involve reassuring the worried individuals that TB is prevalent in South Africa, and exposure to the bacteria is common in everyday settings. I would emphasize the role of the immune system in protecting against TB infection, stressing the importance of a healthy lifestyle to boost immunity. Additionally, I would explain that early diagnosis of TB is challenging, and testing everyone for TB based on proximity to an infected individual may not be beneficial.
Moreover, I would highlight the importance of ventilation in reducing TB transmission and urge individuals to support their affected domestic workers in completing their TB treatment. However, recent developments in TB knowledge have prompted a reassessment of these responses.
A new National TB policy introduced in 2023 recommends testing all close contacts of individuals diagnosed with TB, particularly high-risk groups such as children under five years. Contrary to previous beliefs, people can have infectious TB without exhibiting typical symptoms, emphasizing the need for proactive testing and preventive measures.
Furthermore, the updated national TB guidelines advocate for offering preventive medication to close contacts of TB patients after ruling out active disease. This approach aims to reduce the risk of TB transmission and prevent the progression of latent TB infection to active disease. These preventive measures, including shorter medication courses, are now more accessible to a broader range of individuals at risk of TB.
In light of these new findings, my approach to addressing concerns about TB infection risk has evolved. I now emphasize the importance of testing close contacts for TB, offering preventive medication to those at risk, and encouraging support for TB patients to complete their treatment. By following these updated guidelines, individuals can better protect themselves and their families from TB transmission.
In conclusion, while TB remains a significant public health challenge in South Africa, advances in TB research and policy have provided new insights into the prevention and management of the disease. By staying informed and taking proactive measures, we can work towards reducing the burden of TB in our communities and improving overall health outcomes.
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