Cape Town alone notifies more TB cases than the whole of the USA, UK and Switzerland do every year.
Additionally, says Professor Linda-Gail Bakker, director of the Desmond Tutu HIV Centre, in South Africa, “if you go to prison today, you will get TB”, one of the reasons being the overcrowding in the prison’s remand area, where inmates awaiting trial have to sleep in shifts due to a lack of beds.
Bekker was speaking on Friday at the first in a series of “Science for the People” seminars hosted by GroundUp and Bertha House in Cape Town. Bertha House is a global human rights foundation that supports activists, storytellers, and lawyers working to bring about social and economic justice and human rights for all.
Her talk was titled The science of TB prevention and treatment, writes Daniel Steyn for GroundUp.
Bekker said Pollsmoor needed to be rebuilt if TB is to be brought under control at the prison and that, “In Cape Town, we live in a sea of TB, I’m sorry to say, yet most of us go about our lives without being aware of it”.
The bacteria causing TB is latent in most people, but in cases where it causes disease, it is deadly. People with HIV and diabetes are particularly at risk of severe illness. Treatment for TB involves taking antibiotics for six months. “If you don’t treat it, it’s going to kill you eventually,” Bekker said.
As a notifiable disease, every detected TB case must be reported to the National Institute of Communicable Disease (NICD). Bekker said that as the HIV epidemic hit South Africa, the country experienced a spike in TB infections and deaths. Efforts to get TB under control have not worked, and been hampered by the Covid pandemic as resources were seconded to fight the new virus.
While Bekker stressed the importance of increased screening, testing, and treatment, she also emphasised the hurdle caused by structural issues like inadequate housing. Overcrowding in homes and lack of ventilation increase the transmission of TB. “Unless we deal with structural issues, we’re not going to get TB under control,” she said.
Ventilation, distancing and mask-wearing are crucial to prevent transmission. Prevention therapy, earlier diagnosis and sterilisation, and sustained care need to be improved to better treat people with the disease, she added, “but we also need an effective vaccine”.
Because TB is most prevalent in lower-income countries, there has not been enough pharmaceutical innovation. Most of the antibiotics used to treat TB today have been used since the 1960s. In recent years there has been some innovation taking place, she pointed out, but not enough.
GroundUp article – “Rebuild Pollsmoor prison” says TB expert (Creative Commons Licence)
See more from MedicalBrief archives:
Why independent healthcare for prisoners is vital – Judge Edwin Cameron
Ground-breaking research facility samples TB from breathed air
US CDC’s local chief gets bail because of SA’s bad prison hygiene
World TB Day – Drug-resistant TB spreading; poor infection control in SA
Drug-resistant TB mostly being spread person-to-person in SA