/ 6 February 2021

Most people with TB don’t seek treatment, HSRC survey finds

Widespread tuberculosis awareness campaigns can rein in its increasing transmission rates.
Widespread tuberculosis awareness campaigns can rein in its increasing transmission rates.

About 66% of people in South Africa with tuberculosis do not seek treatment in a country burdened with the illness, according to the Human Science Research Council’s (HSRC’s) 2018 survey, which looked at the prevalence rate of the disease in adults aged 15 years and above. 

Speaking at a virtual meeting organised by the department of health, the HSRC’s Dr Sizulu Moyo said the survey —  which was to have been released last year but was delayed because of the Covid-19 pandemic — found that 68% of those who were HIV negative had TB. It was also found in 82% of those were in the 15 to 24 age group and “by sex, we can see that it was more in males (71.3%) than in females (63.4%)”. 

“We estimated the prevalence overall to be 852 per 100 000 population. It was higher in men at over a thousand, and in females, it was 675 per 100 000,” said Moyo. The survey was undertaken to enhance TB control by informing the TB control programme about the epidemiological situation and giving an insight into how TB control can be improved.

Archbishop Mbulelo Dyasi, the secretary general of the men’s sector at the South African National Aids Council, told Mail & Guardian that he was not surprised by the survey’s findings. 

“As the men’s sector, we had been calling on the government to declare TB a national crisis. We are struggling to get the communities involved in TB programmes because the information is outdated; there are no fresh ideas and new campaigns focused on TB.”

Dyasi said the disease’s stigma prevents people, especially men, from seeking medical care. “Our people still believe that TB is only found in the mining communities. Some even believe that TB no longer exists because there are limited programmes that focus on it.”

The survey also found that two-thirds of those who participated in it did not seek care at any health care facility. These were mostly younger people who were male and were HIV negative. More than 60% of participants said that they did not seek care because they were still planning to do so, 26.6% said their symptoms were not serious and 6.5% said they had no money for transport.

Health Minister Dr Zweli Mkhize said the socioeconomic conditions for many in the country were a driver in the prevalence rates of TB. 

“Interventions must integrate an effective strategy to deal with socioeconomic determinants through a coordinated effort with all stakeholders that empower communities. This should include expanding the social protection network to rich and the poor, vulnerable and disadvantaged groups,” he said.

The minister also outlined plans to curb the spread of the disease by integrating TB services with existing programmes such as the men’s health strategy of 2020/2025 and leveraging technology used for Covid-19. 

Mkhize also noted that a higher proportion of HIV negative people have asymptomatic TB than people living with HIV. 

“Previously, we focused on symptomatic patients and those living with HIV. We now need to encourage everyone to screen and test for TB to achieve elimination.”
Dyasi said that people wanted to see politicians taking the lead in screening and testing TB programmes just the same as they are in raising awareness on Covid-19. 

“I think that we made a mistake as civil society and the government of associating TB with HIV in previous campaigns. We need to correct this because people don’t seek TB services out of the fear of being stigmatised. And since people like our Deputy President David Mabuza is a patron of the men’s movement, we are calling on him to lead the campaign against TB.”