Testing, the mainstay of SA’s TB programme, took a big downturn during lockdown

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  • TB testing has dropped by 32% since lockdown
  • Experts are now looking for missing cases
  • TB is the leading cause of death in SA

Testing for tuberculosis (TB) has dropped by 32% between March and October this year, according to Dr Harry Moultrie, Senior medical epidemiologist at the National Institute for Communicable Diseases’ Centre for Tuberculosis.

The impact of Covid-19 driven lockdown has caused a gap in finding new cases. "It is estimated that between the beginning of March and the end of October this year, 501 000 (uncertainty range: 406 000 - 597 000) fewer TB tests were conducted and 27 500 (uncertainty range: 20 500 - 35 000) fewer positive samples were detected as a result of Covid-19,” says  Moultrie.

Dr Francesca Conradie, a principal investigator at the Clinical HIV Research Unit is calling for a renewed focus to find the missing cases.

It is too early to tell how far below this figure we are for 2020. For HIV-positive people, the risk of developing TB is far greater. Among people with latent TB infection, HIV infection is the main risk for progressing to TB disease. 

“South Africa has a robust TB testing programme. Every year, we know how many tests we need to conduct to find TB cases. There were 207 000 laboratory-confirmed TB cases in SA in 2019. It is too early to tell how far below this figure we are for 2020.

"For HIV-positive people, the risk of developing TB is far greater. Among people with latent TB infection, HIV infection is the main risk for progressing to TB disease.”

Devastating impact

According to Statistics South Africa, TB is the leading cause of death in South Africa. In 2019 a total of 58 000 people died of TB. Of these, it is estimated that 36 000 were HIV positive.

To fill the missing gaps that were caused by lockdown, Conradie recommends that health workers test patients who present TB symptoms, especially people living with HIV.

“People with symptoms should also ask for a TB test. TB spreads very easily because it is airborne. If left untreated, it is life-threatening. Delays in treatment can have a devastating impact on a person's health while spreading it to others,” she says.

But the missing cases are slowly being found says Conradie.

"Doctors in the field are saying that the number of TB cases is increasing to where it should be for South Africa to know it is dealing effectively with the disease, but the data to support this must still come through," she explains.

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