To mark World Tuberculosis Day on 24 March, the City of Cape Town and the Provincial Department of Health urge all community leaders to wear a mask in solidarity with the millions of people around the globe afflicted by this preventable and curable disease.

“Tuberculosis (TB) is spread from person to person through the air by micro-droplet nuclei that are produced when a person with TB of the lungs coughs, sneezes or sings. The micro-droplets are very small and can be kept airborne for long periods of time when there is insufficient ventilation” says Dr Ivan Bromfield, Executive Director for City Health.

This year, City and Provincial Health authorities have embarked on extensive public education programmes with NGO partners to curb TB transmission by improving ventilation and practising ‘good cough hygiene.'

“Communities need to be enlightened about the risk of transmission in overcrowded, poorly ventilated spaces, and how to maximise natural ventilation through opening windows,” says Dr Bromfield.

Health officials are engaging with taxi owner associations to urge taxi drivers to keep vehicle windows open and to encourage good cough hygiene among commuters.

On World TB Day, taxi drivers will be given masks to hand out to commuters who have a cough, as well as stickers with the slogan: ‘Stop the spread of TB, open the windows.'

Commuters at major transport interchanges will also be given health tips and asked to wear masks in an attempt to reduce the stigma around mask wearing in communities.

“We need to detect and treat TB suspects as early as possible because an untreated TB patient can infect another 10 people in one year," said Dr Bromfield.
Families of TB patients are encouraged to improve ventilation in their homes and arrange separate sleeping quarters for the TB patient whilst he or she is infectious. This will reduce the risk of transmitting the disease to vulnerable household members, who typically include children under 5 years of age and immuno-compromised household members (i.e. those who are HIV positive, and/or diabetics) and the elderly.

People who experience a persistent cough, tiredness, night sweats, and weight or appetite loss are encouraged to visit a health facility for a free TB sputum test.

“Thanks to the commitment of its health workers and NGO partners such as the TB Care Association, Medecins Sans Frontieres and Treatment Action Campaign, the City of Cape Town has maintained consistently high cure rates for TB. For the first quarter of 2008, it achieved an overall cure rate of 80% for new smear positive cases. Of the 92% of TB patients tested for HIV, 51% were found to be HIV positive,” says Dr Bromfield.

Common questions about TB:

What are the symptoms of TB?
One of the main signs is coughing for longer than two weeks. Other signs are night sweats, weight and appetite loss and fatigue.
If you have any of these symptoms, please visit your nearest clinic as soon as possible for a free TB sputum test. You can have TB without having a cough.

What health tips can we follow?
Cover your cough and practice good cough hygiene:
Turn your head away from people when you cough or sneeze and cough into your upper arm if you do not have a tissue or toilet paper on hand.
Use a tissue to blow your nose, or spit and throw the used tissue into a bin.
If you have a cough, cover your mouth and nose by wearing a mask or scarf when you are in enclosed or crowded spaces.

Clinics will provide masks to all patients visiting the health facilities free of charge.
Wash your hands continuously so that you do not transmit germs.

What if you stop your TB treatment?
TB patients must continue with their treatment for at least six months or until they are confirmed as TB free. If TB medicines are stopped too soon, the patient may get sick again, in which case the disease will be more difficult to treat. TB patients could also develop drug resistant TB, the treatment of which is longer and the drugs not as effective.

What is drug resistant TB?
TB germs can become resistant to the normal drugs used to treat TB. This can happen should the TB patient be in contact with someone who already has drug resistant TB or if they stop taking their normal TB drugs before they have been cured. A patient with drug resistant TB will need treatment for at least two years. These drugs are very expensive. If a patient stops taking treatment for drug resistant TB, the TB germ may develop further resistance, meaning that the disease is even more difficult to treat.

Eat lots of fresh fruit and vegetables, exercise and rest. Cut down on smoking, drugs or alcohol as these affect the effectiveness of TB medication. Encourage TB patients to take their medication daily and to visit the clinic for regular check ups.

Can TB be cured?
Yes, if you take your treatment as prescribed by the nurse or doctor. TB can be cured even if you are HIV positive. Drug resistant TB can also be cured, but it takes longer and the drugs have more side effects.

How can children be protected against TB?
Children under 5 years of age are more at risk of picking up TB, meaning that those who have been in close contact with an adult TB patient must report to the clinic. The clinic will examine the child to see if he or she needs treatment. If the child does not have TB, tablets will be given to him or her to prevent TB from developing.