KZN Doctor Makes Huge Strides in Fighting TB
Dr Suveer Jhugroo greets me with a big smile as I enter his Pinetown practice to present his award from the Connect TB team for submitting the most patient samples for testing since UKZN’s pilot project began in May this year.
Jhugroo is a friendly man who cares passionately about his patients and the evidence is on the faces of the staff and patients in his waiting room. It’s not an easy time to be a general practitioner - in the midst of South Africa’s third wave of COVID-19, patients and staff are anxious, and the recent unrest in KwaZulu-Natal has also affected doctors in the area. But it takes more than that to keep this good doctor down!
He shows up bright and early to start his working day. If a patient is coughing, he takes appropriate precautions and asks the patient for more detail because COVID-19 is not the only cause for concern - the eThekwini district has one of the highest rates of tuberculosis (TB) nationally and the illness is the number one cause of death by infectious disease in South Africa.
Similar to COVID-19, a cough is a common symptom of TB, which most often affects the lungs. The disease is also spread through contact between people but differs from the Coronavirus in that it is transmitted through the air only by a cough, and not through contact with surfaces and personal contact such as hugs and handshakes.
TB symptoms also take longer to develop after exposure compared to COVID-19 - it could be several weeks or even years before the disease manifests itself as the bacteria can hibernate in the lungs or other parts of the body for long periods. Other common TB symptoms include weight loss, night sweats, and fever.
Importantly, TB is curable with treatment. The sooner a person is diagnosed and starts treatment the better chance they have of making a full recovery… and that’s where Jhugroo comes in.
In his participation in the UKZN pilot study known as Connect TB, Jhugroo has been able to collect spit samples from patients with TB-like symptoms for free TB testing through the National Health Laboratory Services (NHLS). His efforts won him the award for the most samples collected since the launch of the campaign.
The pilot study is intended to reduce delays in TB testing for patients who first present to the private sector. Previous research has shown that patients with TB symptoms who seek help from private GPs are either sent home with ineffective antibiotic treatment or referred to the public sector to access free TB testing. Both practices can delay diagnosis which contributes to poorer patient outcomes and ongoing TB transmission. The overlapping symptoms of TB and COVID-19 have also resulted in further delays, as patients with coughs are often assumed to have COVID-19.
Signing on to Connect TB has helped local GPs connect symptomatic patients to TB testing without having to leave the GPs office, making it simple to test for both COVID-19 and TB when necessary. Patients who are diagnosed with TB through the study are referred for treatment via SMS, which speeds up the process and reduces the number of healthcare visits. Patients are also supported through six months of treatment by adherence facilitators who contact them regularly by phone to check on their well-being and assist with resolving treatment barriers. Adherence facilitators are then able to give feedback on patient progress to participating GPs, closing the loop when patients choose to receive TB treatment through the public sector.
Recognising the importance of early TB detection and differentiating TB from COVID-19, Jhugroo signed on early to the Connect TB project.
Almost a quarter of the samples submitted by Jhugroo tested positive for TB - a sign that the project is indeed helping to find people with TB who might otherwise have been delayed or lost to the system.
True to form, Jhugroo’s response to receiving the award was to place the focus back on his community: ‘My patients are very happy about the support for testing. I am just glad to be part of this initiative and make a difference,’ he said.
The Connect TB project at UKZN is led by principle investigators Dr Jody Boffa and Dr Tsholofelo Mhlaba, and project manager Dr Buyisile Chibi. It is made possible through a partnership with the KwaZulu-Natal Department of Health, the eThekwini health district, NHLS, and funding from the Stop TB Partnership and the Bill & Melinda Gates Foundation.
Dr Buyisile Chibi of UKZN’s Centre of Rural Health is project manager of the Connect TB Study.