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March is TB Month

Sister Judi Joubert gives us some more information on the illness


TB has been around since time began. Through the centuries it has been known by different names. There was no cure.  With modern antibiotics and completion of treatment, there is an excellent rate of cure.

TB is one of the leading causes of death in SA.

TB is caused by a bacterium, Mycobacterium Tuberculosis, that is spread through droplets in the air, from an infected person coughing, sneezing, talking or spitting.


Usually affects the lungs (pulmonary TB), but can be found in any part of the body. (extra pulmonary TB) this is harder to diagnose, but treatment is the same, only longer – 9 months instead of 6 months.

Multi resistant TB, usually due to defaulting on the treatment, so a resistance is formed to some of the antibiotics used.

Various factors play a role, lack of education, a schlep to take medicines every day, time off work to attend clinic, feeling better and social stigma also plays a huge role.


TB is curative and preventable.

There are 2 types of TB – latent and active.

Latent means the bacteria is present in the body, but the person is not infected and has no symptoms. Most South Africans are exposed to the bacteria, but due to a good immune system, nutrition and hygienic living conditions, they may never present with active TB.

Active TB means the person is showing signs and symptoms of TB. Their immunity has been compromised, could be due to immunocompromising drugs (e, g chemotherapy, immune suppressants,) HIV, nutritional deficiencies, poor nutrition, poor hygiene and cramped living conditions with poor ventilation.


In South Africa, a baby is immunised against TB by giving them a BCG vaccine, at birth. It does not ensure lifelong protection, but if exposed, duration shorter and the child not as sick.


Signs and symptoms of TB

  • Cough lasting longer than 3 weeks, with phlegm, later blood stained
  • Chest pain on coughing
  • Drenching night sweats
  • Fevers and chills
  • Loss of appetite
  • Loss of weight
  • Feeling tired all the time.


Diagnosis is made by testing a sputum specimen from a patient. An x-ray may also useful in the diagnosis.


Treatment consists of an initiation / intensive phase of a combination of 4 anti mycobacterials for 2 months. The sputum is tested again and if negative, they are started on a combination of 2 antimycobacterial, known as the continuation phase.


Initially side effects may be very unpleasant, they can experience nausea, vomiting, liver complications, burning feet and the bodily fluids may turn orange. This is where education is important, but often not given, resulting in non-compliance and relapse. Statistically 1 in 3 patients default due to side effects.


This is where Midlands Hospice plays an important role in supporting, educating and encouraging the patients to remain compliant and complete the treatment.  They need to eat prior to taking medication, as this helps combat nausea, and with no appetite it is difficult to eat, an instant porridge is given, so they can have a small amount, in the stomach to buffer against the nausea.  We educate re side effects and help them manage any that may arise. Once they have successfully completed the treatment, we discharge them.


We are also available to give talks in the workplace, to help raise awareness and with knowledge, early diagnosis and treatment.

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