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World Tuberculosis (TB) Day

Published: 31st May 2021
Author: By Professor John Smallwood; Department of Construction Management; NMU

First AIDS, now Covid-19, have been seen as major threats to human health in South Africa. Yet neither has killed anywhere near as many people as lowly and often forgotten tuberculosis which, according to The World Health Organisation, killed 63 000 people in SA in 2018, while 310 000 contracted it. TB is a slow killer, so the two figures aren't a comparison, but it is clear that TB is a far more deadly disease then Covid-19, despite the facts that it is far better understood than Covid-19 or AIDS, and much more easily preventable than either of them.

Introduction: According to Chihota (2021), during 2019, 10 million people were inflicted with Tuberculosis (TB) and close to 1.4 million people died globally, most (95%) of the cases occurring in low- and middle-income countries.
Furthermore, it is estimated that a quarter of the global population is infected with TB, which equates to approximately 1.8 billion people (Chihota, 2021). Therefore, TB is a major cause of illness and death globally.
Within the context of South Africa, TB was ranked first in terms of the underlying natural causes of death in for the years 2015 - 2017, contributing 7.2%, 6.5%, and 6.4% (Statistics SA, 2017).
 
Past construction TB-related research: A study conducted among ‘better practice health and safety (H&S)’ general contractors (GCs) by Smallwood and Venter (2001) addressed, among other, TB. Pamphlets / Flyers, and posters predominated, followed by induction in terms of ten interventions arranged / undertaken by GCs relative to TB. Employee health, employee quality of life, and productivity predominated among eight aspects in terms of the perceived future impact of TB on construction / society. Newsletters and pamphlets / flyers predominated, followed by awareness education (speaker) and posters in terms of the extent eight employer-related interventions would
help to combat TB. Employee health and employee quality of life predominated in terms of the perceived impact TB has had on construction / society in the past. Lack of awareness, lack of education, and socioeconomic conditions predominated in terms of the perceived extent to which five aspects have contributed to the spread of TB.
A more recent study conducted by Smallwood and Deacon (2016) among ‘better practice H&S’ GCs addressed primary health promotion (PHP) in South African construction. PHP was ranked last in terms of the importance of nine parameters to respondents’ organisations. TB was ranked fifth in terms of the extent to which workers benefit or would benefit from sixteen primary health issues being addressed in the work place. TB was addressed between annually to quarterly / quarterly in terms of the frequency respondents’ organisations address sixteen primary health issues with workers.
 
Workplace settings with increased risk of TB: The World Health Organization (WHO) (2003) highlights workplace settings and the causes of increased occupational risk: cramped living quarters and potentially poor health conditions; silicosis; exposure to infected individuals, and migrant workforces in terms of related poverty, poor sanitation and living conditions, and birth in countries with high TB infection rates.
 
Recommended work place interventions: The WHO (2003) refers to the following opportunities for workplace TB control activities: education and awareness regarding TB as part of general or occuptional employee health education and awareness activities; advocacy in terms of TB control; referral of employees with TB symptoms to the nearest health facility for diagnosis and treatment, and support of TB patients during their treatment, including directly observing their treatment.

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