World TB Day

When Government Employees Medical Scheme (GEMS) member, Carol Mashigo* contracted TB last year, she knew that her disease was curable if she followed her doctor's instructions correctly and took her TB medication every day until she finished her whole course. Unfortunately many people do not take their medication properly and are at risk of developing a dangerous strain of TB known as drug-resistant TB, which can be very difficult to treat.

March is TB Awareness Month, which aims to educate South Africans about how to prevent, manage and control TB. Although the disease is curable, TB continues to be a leading cause of death in South Africa causing approximately 12% of deaths every year. The disease is also emerging as a new scourge in the form of drug-resistant TB, which means that the bacteria that cause TB are becoming increasingly resistant to anti-TB medication. This is one of the reasons why TB remains a major killer.

What is TB?
TB is an infection that is caused by a bacterium called mycobacterium tuberculosis, which is spread from person to person through tiny airborne droplets. The germs are spread through the air when a person coughs, sneezes, spits or talks. TB most commonly affects your lungs but it can also spread through your lymph nodes and blood stream to any organ in your body.

Although you may have TB bacteria in your body, a healthy immune system can often prevent you from becoming sick. However there are a number of diseases and medications that can weaken your immune system and make you more susceptible to TB such as HIV/AIDS, diabetes, kidney disease, cancer, malnutrition and very young or advanced age.

Doctors usually make a distinction between latent/inactive TB and active TB. Latent/inactive TB is when the bacteria remains in your body in an inactive state and causes no symptoms and is not contagious. If you have a weakened immune system, latent TB can turn into active TB, and treatment is important because active TB can make you very sick and it can spread to others. How do you know if you have TB? Well, you should watch out for symptoms. These can include:

• unexplained weight loss;
• fatigue;
• shortness of breath;
• fever;
• night sweats;
• chills;
• loss of appetite;
• coughing that lasts up to three weeks or more;
• coughing up blood or sputum (a mixture of saliva and mucus);
• chest pain.

According to the World Health Organization (WHO), these symptoms may be mild for many months, which can lead to delays in seeking treatment and result in people spreading the disease to others. People who have active TB can infect 10 to 15 people through close contact over the course of a year.

When to contact your doctor
When Carol experienced some of these symptoms she went straight to a doctor in the Friends of GEMS network, who diagnosed the condition as TB and prescribed her suitable medication. TB is a prescribed minimum benefit (PMB) meaning that if you belong to a medical scheme, your scheme is obligated to pay for the diagnosis, treatment and care costs of the condition.

Carol was fortunately a member of GEMS, and the Scheme was there to support her every step of the way. Treatment for TB can include a combination of medications for a period of 6 to 18 months, depending on whether you suffer from non-drug resistant TB, multi-drug resistant (MDR-TB) or extreme-drug resistant (XDR-TB).

Treating TB
Carol knew that TB can be fatal if not properly treated, that is why she took her medication regularly and finished her entire course. Today she is once more happy, healthy and completely TB-free. The WHO estimates that without proper treatment up to two thirds of people ill with TB will die. However, TB can be cured with proper treatment and care. Resistance to anti-TB medications occurs when patients do not take their medication properly or when healthcare providers prescribe the wrong treatment, the wrong dose or when medicine supply is unreliable. Treating MDR-TB and XDR-TB is very expensive and often causes severe side effects.

If you are diagnosed with TB, it is vital that you take all of your medications exactly as prescribed by your doctor. TB medication is meant to kill the bacteria that cause TB, and the bacteria can remain in your body even when you start to feel better. Therefore it is imperative that you complete your whole course and do not miss even a single dose. If you do not take your medication regularly you may be at risk of developing MDR-TB and XDR-TB.

For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

Sources
World Health Organisation (WHO):  http://www.who.int/topics/tuberculosis/en/
Medical News Today:  http://www.medicalnewstoday.com/articles/8856.php
The Mayo Clinic:  http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/definition/con-20021761

Carol Mashigo* - name changed to safeguard the privacy of Scheme member.