TB can be beaten: early detection is crucial

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Alvine Kapitako

Windhoek-It was with utmost shock and dismay that 24-year-old Levi Johannes received the news in September last year that he was suffering from tuberculosis (TB).
Tuberculosis is a potentially fatal contagious disease that can affect almost any part of the body, but is mainly an infection of the lungs.

Johannes’s nightmare began when he started to lose weight. He also experienced hot and cold flushes all over the body and had an unending cough.

“The people in the community were saying that I have HIV, because I became thin and lost energy. I decided to go to hospital to test for HIV and TB. The test for HIV came back negative and for TB came back positive. It was hard for me to receive the news that I had TB,” related Johannes.

A security guard at a local company, Johannes explained that he was admitted to hospital for a month, after which he was put on sick leave for a month and a half.
Johannes told New Era that he does not know how TB spreads, but he suspects that he might have contracted the disease from drinking too much alcohol.

“I don’t know how I got it or when I got it. People say it’s in the atmosphere,” says Johannes, adding that his immediate family did not contract the disease before or after his diagnosis.

Johannes says he had to strictly adhere to his medication and on March 10, he completed his TB treatment. Some people with TB do not adhere to their medication, Johannes noted.

“If a person who is suffering from TB does not adhere to their medication, their condition can deteriorate to the point of death. Or they can become disabled, especially their backbone can be affected and their knees can become weak,” he warned.
He urged young people to limit their intake of alcoholic beverages. And, if they cannot limit their alcohol intake, they should stop.

“When people are drunk and intoxicated with drugs they lose control and engage in unprotected sexual activities, which exposes them to HIV. HIV is one of the reasons why some people have TB,” added Johannes.

The larger picture
Namibia reported a marginal increase in the number of TB cases from 9,882 cases in 2014 to 9,944 cases in 2015, according to statistics obtained from the Ministry of Health and Social Services. The number of reported cases of multi-drug resistant TB also increased from 137 to 190 during the same period.
Dr Takura Razemba of the Khomas Medical Centre explained that TB is spread by droplet infection.

“This happens when a person who has TB of the lungs or throat coughs, sneezes, sings or talks, releasing droplets which contain the bacteria into the air, where they can be inhaled by an uninfected person and then cause disease,” Razemba explained, adding that it is important for TB to be detected early.

All the people who were in contact with a TB patient report must go for physical examination and if necessary testing and treatment, he added.
Some ‘at risk groups’, such as children, can then be given medication early on to prevent them from getting a serious TB infection, he added.

HIV patients are likely to develop TB mainly due to how the bacteria interacts with the body’s immune system, he pointed out. United States Ambassador to Namibia Thomas Daughton said this week that Namibia has one of the highest HIV-TB co-infection rates in the world.

That means that, on average, about four out of every ten patients with TB are also HIV-positive, Daughton remarked during his visit to Okuryangava Clinic, where he amongst others interacted with TB patients.

“In HIV negative people, inhalation of the droplets may not lead to disease, because the body’s immune system quickly recognises the infection and creates a sort of wall around it which prevents it from affecting the lung,” explained Razemba.

But, with HIV, there is possible impairment of the immune system, he said. “This makes it difficult for the body to act and respond appropriately to the bacteria. The protective wall is not formed and the infection is allowed to take hold and damage the tissues,” he said. Also, previously healthy individuals who were exposed to TB but never had an active TB infection may develop active TB, explained Razemba.

“As the immune system weakens under the effects of the HIV, the immunological ‘wall’ that was around the bacteria breaks down, allowing it to become active again. This is called ‘reactivation TB’,” he said

According to the Ministry of Health and Social Services, in 2015, 95 percent of TB patients were tested for HIV and 92 percent of TB-HIV co-infected patients were on antiretroviral therapy.

“The number of TB patients who are HIV infected has been declining since 2009,” according to a report by the Ministry of Health.
The World Health Organisation estimates that people living with HIV are 26 to 31 times more likely to develop TB than the rest of the population.

Treatment
According to a 2016 report by the Ministry of Health and Social Services, the national target for treatment success rate for all forms of TB in 2014 was 90 percent.
The reported treatment success for this period was 85 percent, with significant variations between regions. The target treatment success rate was achieved in the Omaheke and Zambezi regions.

TB in correctional facilities
Further, in 2015 the Namibia Correctional Services reported 18 cases of TB in correctional facilities, according to the report.

“The Namibia Correctional Service and the Namibia Police Force were supported by Global Fund through the National Tuberculosis and Leprosy Programme to participate in international exchange tours to Swaziland and Zambia for benchmarking,” according to an extract of the report.

Today is World TB Day and in Namibia the occasion will be observed at Opuwo.

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