Tuberculosis (TB) is an infectious disease spread by airborne bacteria found in sputum. It is extremely prevalent in South Africa — an estimated 80% of the population has latent TB.
Though pulmonary TB is the most common and contagious form of active TB, the disease can also occur in almost any other part of the body, including the lymph glands, pleura, joints, bones, meninges or intestines and is referred to as extra-pulmonary TB.
People that are immune compromised e.g. living with HIV, are at a greater risk of contracting active TB. Often, the TB will affect more than one organ, and pulmonary and extra-pulmonary TB can coexist.
Identifying and treating TB is crucial to ensuring it doesn’t spread. Left untreated, a person with active TB can infect up to 15 people a year.
Healthcare facilities are one of the settings where there is an increased risk of TB infection. This is because transmission of the disease generally occurs indoors, where infected droplets can stay in the air for a long time especially if there is poor ventilation.
That said, the clinic or pharmacy is often the first line of defense when it comes to recognising the symptoms of TB in patients that visit them.
Common symptoms of TB include:
- A cough that has persisted for two weeks or more, often accompanied by blood-stained phlegm.
- Loss of appetite and weight. (≥ 1.5kg per month)
- Chest pains.
- Tiredness and drenching night sweats, usually from a rise in temperature in the evening.
- Shortness of breath.
In complicated cases, patients may cough up blood.
Anyone who visits a healthcare facility with a cough that has lasted two weeks or more should be regarded as a ‘tuberculosis suspect’.
When TB is suspected, at least two sputum specimens should be collected and examined by smear microscopy and culture. Specimens should be collected within two consecutive days and examined as soon as possible.
Should a patient’s TB test result be positive, officials are legally obligated to notify the Department of Health.
The outcomes of a TB examination may vary, and the resulting cases can be categorised into the following types:
- A new case is when the patient has never been treated for TB or has been receiving treatment for less than four weeks.
- A relapse case is when the patient tests positive after being declared cured of TB after completing a course of treatment.
- A treatment failure case occurs if the patient remains or tests positive after five months of treatment.
- A treatment default case is declared if the patient has interrupted treatment for more than two months.
- A chronic TB case is when the patient remains positive after retreatment.
Efforts to increase the identification of TB cases have been undertaken in settings of high TB and HIV prevalence; the Department of Health runs a number of awareness campaigns, and recommends active screening of high risk groups, as this can lead to early identification.
Allegra’s WellScreen software can assist clinics, and pharmacies with onsite clinics, in identifying and managing patient health risks. For more information please contact: firstname.lastname@example.org.
Links / References:
The South African Labour Guide – TB, what employers should know. Retrieved from http://www.labourguide.co.za/health-and-safety/1374-tb-what-employers-should-know
South African National Tuberculosis Association – TB in South Africa. Retrieved from http://www.santa.org.za/tb-in-south-africa.html
Allegra – Tuberculosis – article by Ronel Reyneke
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