Published On: 31 August 2023


A 20-year-old male came to Ladysmith’s Steadville clinic on March 21 this year, presenting with loss of appetite, loss of energy, loss of weight, coughing and vomiting blood. Signs and symptoms of TB was noted. Sputum for GXP taken, and the result was positive with Rifampicin Resistance – on March 24. He was referred to Ladysmith Hospital for treatment, and subsequently to Estcourt for DR-TB initiation.

Tracing by the Department of Health was done, and seven contacts identified – all tested on March 28, no under 5s included. The THINK team then got an invite from the DoH to come and assist with contact testing at the index patient’s school.

THINK, together with DoH staff, tested 54 learners on March 29 and 8 teachers on March 31. All results were negative.

A need for better health education – specifically on TB, its signs and symptoms, and how it spreads from one person to another – has been identified, as teachers in this case were initially sceptical about being tested due to lack of information.

“Thank you so much for the information and the understanding that you have given us about TB. We received our test results quickly, and were so grateful that they were negative.”

– Mrs NG Ndlovu, Deputy Principal at Steadville High


A 12-year-old male from the Vaalkop area, a learner at Mzimela High School, presented to the Department of Health’s St Chads CHC with TB symptoms and tested positive for MDR-TB on February 24 this year. The patient was initiated on MDR treatment and household tracing was done, where two under 5s and five over 5s were tested. None were positive, and the two under 5s were initiated on TPT on February 27. The patient had been in contact with his aunt, who was concealing that she had tested positive for DS-TB – and had not been initiated on treatment until she had relocated to Johannesburg.

On March 7, together with the DoH outreach team from St Chads CHC and the THINK mobile CXR, a mass screening was done at Mzimela High School – for teachers and learners in the same grade as the index client. 150 sputa were collected and 50 CXR done. Four learners tested positive for DS-TB and were initiated at Rockcliff clinic accordingly. Having reported more positives, the school principal requested that the whole school be tested. On March 30, the rest of the school was then screened – where 300 learners and 30 teachers were tested for TB. One teacher tested positive for DS-TB, and one learner tested positive for MDR-TB and was initiated on treatment at Estcourt hospital. 

The DoH district office has declared a TB outbreak in this area, plenary meetings and talks are underway for an intervention to the outbreak. There are talks between the NDoH, relevant DSPs, and stakeholders to intervene at school, community and household level.

This story really shows the importance of prompt and consistent tracing and mass screening to curb the spread of TB in our communities.

Thank you, THINK uThukela team, for making a difference!