Screening through Chest X-Rays a more accurate diagnostic tool for scores of untreated South African TB patients
Diagnostic Imaging Specialists, Keystone Radiology, says the screening of Tuberculosis patients through Chest X-Rays will prove much more effective in identifying scores of untreated TB patients, than just relying on symptom identification. This comes as the world celebrates World TB Day today on Wednesday, 24 March, and merely a few days after South Africa’s long-awaited TB prevalence survey results were released. The results indicate that the country has a far higher number of people with TB than previously thought. Dr Jacqui Henning says many people are living with TB who have not yet been diagnosed or treated.
‘TB is South Africa's leading cause of death and it’s estimated that at least ten people die of the disease ever hour. The latest results are quite alarming, showing that that 360 000 new cases of TB were diagnosed in 2019, far higher than the 301 000 cases in 2018. The World Health Organisation estimates that in 2019, 58 000 people died due to TB in South Africa, and an astonishing 1,4 million deaths globally, of which 208 000 also had HIV,’ says Henning.
Tuberculosis is an infectious disease that spreads via droplets produced when speaking, sneezing, spitting or coughing, and affects mainly the respiratory system of the body. Henning says there are two main forms of the disease, namely latent and active TB.
‘Latent TB means that the bacteria is present in your body, but you are asymptomatic or without symptoms. At this point you are not contagious, and your immune system is fighting the bacteria. Active TB means that the bacteria is actively replicating and causing symptoms. During this stage of the disease, TB is highly contagious. About a quarter of the world population has a latent TB infection, and of these people, 5-15% have a lifetime risk of developing active TB,’ she explains.
Henning says TB remains one of the leading causes of death in South Africa despite being a curable disease.
‘TB can be treated with a combination of antibiotic drugs for a duration of 6 months or longer depending on the type of disease. In some cases, the TB can become multi-drug resistant when left untreated or not fully treated to destroy the bacteria completely, causing the bacteria to build resistance against the medication. Without treatment, approximately 45% of HIV Negative and all HIV Positive patients will die,’ Henning says.
The recent TB survey was conducted between 2017 and 2018 by the South African Medical Research Council, Human Sciences Research Council and the National Institute for Communicable Diseases on behalf of the Department of Health. Henning says an extremely important finding was that most people who tested positive for TB in the survey, did not experience any of the classic symptoms such as fever, weight loss and or appetite loss, night sweats, a persistent productive cough and as fatigue.
‘The sad truth is that TB is curable, however, many people are ignorant of the fact that they have the disease, while others’ treatments are delayed, which in turn could cause prolonged ill-health. TB sometimes renders patients unable to undertake their normal daily activities to the extent that many are unable to work, resulting in economic hardship for themselves and their families. What is also important to note, the longer a person is untreated, the more likely they are to pass the infection on to other people and continue the cycle,’ Henning explains.
People with TB can infect as many as 5-15 other individuals through close contact over a one-year period. Henning says the survey flagged more important information such as the fact that the majority of patients who have not yet been diagnosed was HIV-negative men.
‘This particular section of the population is less likely to visit a clinic and therefore the chance of them being diagnosed in time for effective treatment is also dwindling,’ Henning says.
Henning says the ongoing Covid-19 pandemic has also had a devastating impact on the number of people being tested and receiving TB treatment.
‘The numbers indicate that TB testing rates have dropped dramatically, especially during the strict lockdown periods last year when hospitals and clinics had to implement more stringent access protocols due to the fact that they were the port of call for sick patients, many who were Covid-patients. Not only did the testing numbers drop, but it also impacted the treatment of TB patients significantly. This could mean that the number of TB patients could even be higher than the pre-Covid era.’
Henning says in light of the latest information it is critical that the public make use of more accurate diagnostic methods such as regular screening, to ensure that potential TB patients do not fall through the cracks.
‘Keystone Radiology joins the health care community in the fight against TB and emphasizes the importance of screening for Tuberculosis through Chest X-Rays for diagnosis and treatment.’
