By Lehlohonolo Lehana.
World Tuberculosis (TB) Day is commemorated annually on 24 March, to educate the public about the impact of this infectious disease. The date is that on which Dr Robert Koch discovered the TB bacterium in 1882.
Numerous efforts across the globe aim to eradicate TB, says Myrna Sachs of Alexander Forbes Health Management Solutions. "According to the World Health Organization (WHO), just under 210 000 people die from TB each year, and South Africa is in the top 10 countries with the highest TB burden."
The results of a 2018 national TB prevalence survey released this year showed there were 390 000 people living with TB in South Africa. The WHO has a strategy in place to eradicate the disease by 2035.
How does your medical scheme cover TB?
In terms of Annexure A of the Medical Schemes Act, TB is regarded as a prescribed minimum benefit. This means medical schemes need to pay in full for the:
- diagnosis of pulmonary TB
- acute medical management
- successful transfer to maintenance therapy
"This is in line with the guidelines defined by the Department of Health. Medical schemes may enforce members to use a designated service provider to provide the necessary services from consultations, medication, investigations to hospitalisation."
They cannot tell a member that they do not provide cover for any of the related costs and refer them to the public sector to obtain the necessary care. However, Sachs says they may refer a member to a state facility if they have arranged guaranteed access for certain services. “Members must be aware that the scheme may apply co-payments for using a non-designated service provider – but cannot refuse cover."
10 facts about TB
- Around 10 million people were infected with TB in 2019 but only 5 to 15% of these got sick.
- TB is a notifiable disease – each diagnosis is registered and documentation completed to keep accurate statistics of the disease.
- TB infects people of all ages – children, adults and the elderly – and all races and ethnic groups.
- TB can infect any part of the body (spine, brain, abdomen and so on) not just the lungs.
- People are at a higher risk of getting sick from TB if they:
o have prolonged exposure to TB
o they are children under the age of 5
o they have reduced immunity such as in HIV or drug addiction
- Most people who get infected with TB do not get ill. TB can lay dormant as an infection in your lungs for many years without making you sick.
- Diagnosed TB requires consistent treatment for at least six months to cure the disease.
- Inconsistent treatment contributes to TB bacteria which are resistant to treatment. Therefore, it is crucial to complete treatment.
- Multi-drug resistant TB is difficult to treat and unfortunately has a high mortality.
- In South Africa, TB vaccines have been administered at birth since 1973.
Sachs said that symptoms of TB can present with:
- a persistent cough for more than two weeks
- blood in the sputum
- fever and night sweats
- unexplainable weight loss
"TB can be diagnosed through skin tests, or an x-ray or sputum sample analysis, taking a sample of the suspected infected area and looking at it under the microscope and other methods." Some TB diagnoses are difficult to make and may require treatment to be started before a firm confirmation of diagnosis is made.
TB may co-exist with other infections which would require treatment as well, such as pneumonia. TB treatment itself is a combination of antibiotics that must be taken daily, consistently for at least six months, depending on the type of TB the individual was diagnosed with.
"This World TB Day, remember it is a curable disease requiring vigilance. Schedule an early visit to the doctor if you are at risk and suspect that you may need assistance," Sachs said.