Community involvement is essential in bringing health facts to the people and encouraging them to be screened
Tuberculosis (TB) is one of the nation’s most pressing health issues. In the Free State Province TB is managed at primary health care facilities; however, there are dedicated beds at hospitals for TB patients whose condition requires hospitalisation. Susceptible TB is treated for six months.
There are two units for multi-drug resistant (MDR) TB in the province — the Dr JS Moroka District Hospital in Thaba Nchu and the Kopano Unit in Welkom.
MDR-TB patients are treated at the units until their sputum converts to negative, at which point they are discharged to decentralised units, where they receive medication and get treated from home. Outreach teams visit MDR-TB patients at home for further management, and give daily injections to those who are still in the intensive phase (the first six months of treatment).
Complicated forms of TB are treated at the Centre of Excellence at Pelonomi Hospital in Bloemfontein. These cases include children with MDR-TB and patients with XDR-TB (extreme drug-resistant TB). Mobile clinics do regular visits to patients in places that are far from fixed facilities, such as farms.
Mapelele Mosoahle, the Free State’s assistant director responsible for advocacy, communication and social mobilisation within the TB programme, said her role pivots around raising awareness of the personal risks of TB infection in order to enhance positive behavioural changes.
“It is also vital to influence positive social norms and values to restore respect and dignity and promote health-seeking behaviour by South Africans, especially as it relates to screening, counselling, testing and being treated for TB and HIV. We have to develop appropriate communication platforms that allow dialogue, and empower various individuals and organisations to act.
“Community members are encouraged to protect themselves against TB, and also to know what to do if they get infected. People should know the signs and symptoms of TB, which are: continuously coughing for more than two weeks, experiencing night sweats and chest pains, and losing appetite and unexplained loss of weight.
“If a person has any of these symptoms, she or he must immediately visit a clinic to be checked. People confirmed to have TB are provided medicines for free, which they must take daily until a health worker confirms that they have been cured. TB can lie dormant in the system since first exposure for a long time even up to 30 years.”
Mosoahle emphasised the importance of prevention through basic hygiene practices including covering your mouth and nose when coughing, whether you know your TB status or not.
While in some instances it is difficult or impractical, Mosoahle also stressed the importance of keeping windows and doors open, and once diagnosed with TB, how essential it is to take the medication until given the all clear.
“Only after a sputum test taken after two months that shows no presence of bacteria are you then no longer infectious,” said Mosoahle.
“However, I cannot stress enough the importance of spousal and family support and of not perpetuating the stigma. Encourage the person to take their medication regularly as prescribed and do not discriminate or isolate them. You never know if it was a family member or household contact who gave the person TB; [becoming] aware of a [family member having] TB [is] the signal to go and get tested [yourself].
“There is the likelihood that we have [all] been exposed to TB and TB infection, but do not have active TB disease. It depends on the strength of our immune systems for the TB infection to progress into TB disease.
The sun and proper ventilation destroy the TB bacteria. Anyone can get TB, regardless of race or economic status.
Mosoahle urges people not wait for all the signs and symptoms to manifest; if any symptoms occur, go immediately for testing.
“As part of our screening tool, we ask four questions. If you respond to one, we take a sputum test — which is the most reliable test for TB,” she concluded.