A 20-year-old woman from Bizana in the Eastern Cape who was apparently treated treated for tuberculosis (TB) for two years instead of cancer as a result of a misdiagnosis, has died.
TimesLIVE reports that instead of getting better, Sinentlahla Shinga deteriorated, her body weakening, her skin changing colour, and eventually, becoming bedridden.
Her family’s worst fears were confirmed, they said, when doctors at a Port Shepstone hospital told them Shinga had been misdiagnosed – that she didn’t have TB, she had lymphoma, and by then it had already spread throughout her body.
Pinky Qushwana, a relative who took her in before she died, said she was so weak, she couldn’t walk or eat properly.
She said Shinga first went to St Patrick’s Hospital in Bizana in 2023 when she was unwell, and doctors diagnosed her with TB and placed her on a six-month course of treatment. But when her condition didn’t improve, they prescribed another six-month course.
“Even after the second treatment, there were no changes,” Qushwana said. “Her health just kept deteriorating. She had to move in with me because there was no one to care for her where she lived.”
When her condition worsened, Shinga’s family took her to Port Shepstone Hospital, at which stage she was unconscious and hallucinating.
“Doctors found two tumours, one on her neck and another below her private parts. They couldn’t operate on the one in her neck, but removed the other. That’s when they discovered she didn’t have TB at all, it was lymphoma cancer,” Qushwana said.
Shinga died two weeks ago.
A deadly but preventable mistake
Misdiagnosis of TB and cancers such as lymphoma remains a significant clinical challenge in rural parts of South Africa and other countries with high TB rates. Both diseases share overlapping symptoms, including swollen lymph nodes, fever, weight loss and night sweats, often leading clinicians to treat for the more common TB first.
A public health expert told the Sunday Times that TB can usually be confirmed through laboratory testing, making such cases rare but not impossible.
“It’s possible for a patient to have both TB and another disease, like cancer. But without access to proper diagnostic tools or a full patient file, it’s hard to say what went wrong in this case,” he said.
However, studies suggest that misdiagnosis and improper treatment remain widespread issues in the rural healthcare system. A 2021 study published in The Lancet Global Health found a high burden of undiagnosed and misdiagnosed diseases in rural areas, including cases where lymphoma was mistaken for TB, delaying critical cancer treatment.
Eastern Cape Health Department spokesperson Siyanda Manana confirmed that the department was aware of the case.
“It was investigated and is considered a closed matter,” he said, adding that there are processes in place to review cases of misdiagnosis in state facilities.
To address the shortage of diagnostic tools and trained specialists in rural hospitals like St Patrick’s, Manana said the department has deployed a district clinical specialist team, which includes an obstetrician-gynaecologist and a specialist paediatrician.
“This is part of our strategy to place specialists in rural hospitals and improve the overall quality of care,” he added.
There are also several initiatives under way to enhance cancer screening and early detection in the province.
“These include ongoing training of doctors and the provision of screening equipment to hospitals as tools of trade for doctors and nurses to use in detecting cancer,” he said.
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