Tuberculosis (TB): TB (Kgotlholo e tona in Setswana) is a disease caused by an organism called mycobacterium tuberculosis. These bacteria can attack any part of the body, but they most commonly attack the lungs. A person can have active or inactive tuberculosis. Active TB or TB disease means the bacteria are active in the body and the immune system is unable to stop them from causing illness. People with active TB in their lungs can pass the bacteria on to anyone they come into close contact with. When a person with active TB coughs, sneezes or spits, people nearby may breathe in the TB bacteria and become infected. If TB is left untreated, each person with active TB could infect on average between 10 and 15 people every year.
People can also be infected with tuberculosis that is not active in the body (inactive TB infection or latent TB). If a person has latent TB, it means their body has been able to successfully fight the bacteria and stop them from causing illness. People who have latent TB do not feel sick, do not have symptoms and cannot spread tuberculosis. In some people tuberculosis bacteria remain inactive for a lifetime without becoming active. But in some other people the inactive TB may become active TB if their immune system becomes weakened - for example by HIV. People with inactive TB are also called TB carriers.
Co-infection with TB and HIV markedly increases the mortality and morbidity of both diseases and thus represents a public health challenge in Botswana. Active pulmonary TB and extra-pulmonary TB are WHO clinical stage 3 and 4 conditions, respectively. (Pulmonary and lymph node TB are WHO stage 3 conditions for paediatric patients). At every visit there must be clinical screening for active TB infection, i.e., inquiry into the presence of symptoms of active TB infection, with further investigations as indicated.