By Catherine Murombedzi

WHEN a person has a deep cough in public, eyes are cast in that direction enveloped in fear, silently questioning if that is not tuberculosis (TB).
Since TB is spread through the air, there is reason for people to be concerned.
It is, however, not everyone coughing who spreads the TB germs.
People with active tuberculosis are highly infectious before they even know that they have it. Barely 72 hours after starting treatment, TB is no longer infectious. So, there is no need to fear being next to someone already on treatment.
TB is caused by TB bacillus (mycobacterium tuberculosis) that most often affects the lungs. However, TB can also affect any part of the body. Tuberculosis is curable and preventable.
World TB Day is marked on March 24.
When a person with lung TB coughs, sneezes or spits, he/she releases the TB germs into the air.
A person needs to inhale only a few of these germs to become infected.
One third of the world population has latent TB from infancy, which means people have been infected by TB bacteria but are not and cannot transmit the disease.
Statistics show that only 10 percent of latent TB develops into active TB thereby making one ill.
The most at risk are people with a compromised immunity, like people living with HIV, malnourished people, tobacco smokers and people with diabetes mellitus.
Zimbabwe is the 17th highest tuberculosis (TB) burden country in the world.
TB is the second leading cause of severe illness and mortality in Zimbabwe and the most significant contributing factor to the TB burden is the HIV and AIDS epidemic.
Approximately 80 percent of TB patients are co-infected with HIV. (National AIDS Council 2015) This co-infection remains a major factor propelling the high death rate among TB patients in Zimbabwe. Most cases of TB are found in the urban areas of Zimbabwe.
Over the last five years, the number of TB cases detected annually has ranged between 40 000 and 48 000. (NAC 2015)
A closer look at people living with HIV shows that the TB/HIV co-infection is usually diagnosed at the same time after one falls ill.
Dr Owen Mugurungi, the director in the AIDS and TB unit in the Ministry of Health and Child Care, said the country now has collaborative TB-HIV treatment.
“With the TB/HIV co-infection noted in Zimbabwe, it is imperative that collaborative TB/HIV treatment is offered,” said Dr Mugurungi.
Dr Mugurungi said there is need to have the TB and HIV treated at the same time.
“There is need for this collaborative TB/HIV treatment if justice is to be seen in people living with HIV and have TB as well. We have integrated TB/HIV services and we encourage adherence,” said Dr Mugurungi speaking to a forum for ‘Meaningful Involvement of People Living with HIV’ in Gweru early this year.
Dr Mugurungi urged people living with HIV to be screened for TB time and again as they are at risk of getting the disease.
“People living with HIV are urged to get screened for TB as they are at risk of getting the disease,” said Dr Mugurungi.
“The symptoms of TB infection are cough, fever, night sweats, weight loss and lack of appetite. Anyone experiencing these must visit their nearest health facility for screening.”
TB is treated free of charge the world over.
“In Zimbabwe the main tablets used in TB treatment are rifampicin and isoniazid,” said Dr Mugurungi.
“Sputum and X Rays are taken to confirm TB presence which is usually treated in six months.
“Treatment failure is noted when one fails to complete taking the prescribed medication.
“Treatment failure in TB is a result of poor adherence, ineffective regimens, poor storage of drugs which lead to degenerations of the medication.”
Long distances to clinics by people in rural areas is found to be a barrier to patients completing TB medication.
In the 1970s, people with active TB were isolated. However, today, such centres as Makumbe Mission Hospital in Domboshava now offer integrated health services.
Mostly TB is treated by the Directly Observed Treatment regimen (DOT), with one coming from home unless one reports late for treatment and has reason to be admitted.
Active drug-sensitive TB disease is treated with a standard six-month course of four antimicrobial drugs that are provided with information and supervision. TB can be cured when medication is taken properly.
The World Health Organisation (WHO) has in place ‘End TB Strategy’ inspired by a simple motto: ‘Leave no one behind’.
The developed world has overcome the TB scourge by providing decent housing for its nationals. In the developing world, TB is still a challenge as some communities still live in crowded and poorly ventilated structures.
In Zimbabwe TB remains a major killer and the vision to end TB by 2030 can be a mirage if new infections keep rising.