Africa has the highest per capita incidence of TB in the world (28%), with most of the worst affected countries located in sub-Saharan Africa. Those most at risk include the urban poor, migrants and refugees, who are forced to live in overcrowded conditions.
Africa is also the only continent where TB rates are increasing, with 1,500 TB deaths every day. Tragically and avoidably, 10% of these are children. TB is also a leading killer of HIV-positive people with weakened immune systems. About 200,000 people living with HIV/AIDS die from TB every year, most of them in Africa. Completing a particularly vicious circle, HIV itself has been the single most important factor in the rising incidence of TB in Africa since 1990. Treating co-infected people is hard as the drug therapies for each are hard to safely combine.
Dangerous, drug-resistant strains of TB have also now emerged. This is caused by inconsistent, incorrect treatments being taken, or because of unreliable drug supply. Not completing a course of treatment is a key cause of this resistance:
- Multidrug-resistant TB is resistant to the two most powerful anti-TB drugs
- Extensively drug-resistant TB is resistant to second-line drug and is extremely difficult to treat
How AMREF is tackling TB
Working alongside local communities, AMREF is training community-based health workers to raise awareness about how to prevent TB, and to diagnose it correctly. We also advise people to be voluntarily tested as a preventive measure. Because TB treatment is particularly complicated and prolonged, health workers are trained in Directly Observed Treatment Strategy – a method that ensures patients take their medication in the correct way.
Trained health workers raise awareness about hygiene (which will prevent the spread of TB) and about eating nutritious food – a strong immune system will help fight the disease. Patients in some areas are encouraged to plant vegetable gardens to improve their diets and provide exercise.
In South Africa, the Sakhisizwe TB Project has helped identify many more cases of HIV/TB co-infected patients, enabling them to get timely treatment. It has also improved the numbers of people completing their treatment properly, and has boosted the rate of early detection.