Most TB tests still require a trip to the clinic. Now, new technology has made it possible to test people at home. This could be a big deal for South Africa, where much TB goes undiagnosed.

Besides preventing illness and death, TB preventive treatment (TPT) is estimated to be highly cost-effective. Yet, uptake of TPT is not what it could be in South Africa. Tiyese Jeranji asks how much has changed since the Department of Health last year decided to make TPT much more widely available.

An article published in Spotlight elaborates on a series of related trials called XACT, exploring community-based TB testing using battery-operated molecular tests.

People in South Africa who fall ill with tuberculosis (TB) often also have other health issues. HIV, which drives much of the TB epidemic in South Africa, is the most obvious co-infection, but people who fall ill with TB are also more likely to have diabetes and mental health problems than the general public.

According to the World Health Organization, of the roughly 10 million people who fall ill with TB annually, over 80% survive, in most cases due to a six-month treatment course. Unfortunately, as with long COVID, being cured is not always the last hurdle and many people go on to struggle with post-TB lung disease.

Most TB testing today relies on sputum samples coughed up from the lungs. This makes intuitive sense since pulmonary (or lung) TB is the most common form of TB and sputum provides testable samples straight from the scene of infection.

Busisiwe Beko, from Khayelitsha in the Western Cape, was diagnosed with drug-resistant tuberculosis (DR-TB) while she was pregnant. She remembers it as a very difficult period in her life.

TB diagnosis usually starts with asking someone whether they have any of the classic symptoms of TB (coughing, fever, loss of weight, and drenching night sweats in adults). Traditionally, only people who have one or more of these symptoms are offered confirmatory molecular tests.

Falling ill with TB and all the disruption and stress that goes along with it can take a toll on someone’s mental health, and mental health problems can in turn make someone more vulnerable to TB.

Tuberculosis (TB) can be cured, but completing TB treatment can sometimes be difficult. Treatment for drug-susceptible forms of TB takes six months and some of the medicines have side effects. Treatment of drug-resistant TB typically takes more than six months and the risk of side effects is substantially higher.