Undiagnosed TB pose challenge for South Africa, Mozambique

Africa has seen a decline in tuberculosis (TB) cases, yet experts highlight persistent hurdles in combating the disease, especially in South Africa and Mozambique. While progress has been made, challenges like underdiagnosis and drug-resistant strains continue to complicate efforts. Southern Africa remains a hotspot for TB, with nations like South Africa and Mozambique contributing significantly to the global disease burden.

In South Africa, the situation persists as a major concern. The World Health Organization (WHO) reported 54,000 TB-related deaths in 2024, a drop from prior years but not enough to declare the epidemic under control. Helen Hallstrom, a senior officer at ADPP Mozambique, attributed this to the high prevalence of co-infection with HIV. “HIV weakens the immune system, especially when treatment isn’t consistent,” she explained to DW. The country ranks among the world’s top 30 high-burden TB nations, with nearly half of those living with HIV also infected with TB.

“South Africa definitely has a higher burden because of the co-HIV infection [rates],” Hallstrom told DW.

Mozambique faces its own crisis. In 2023, 112,000 people were infected with TB, but 17,400 cases remained undetected. This reflects ongoing barriers in accessing healthcare services. The nation also grapples with drug-resistant TB (DR-TB), which remains a leading cause of mortality, particularly among HIV-positive individuals. Like South Africa, Mozambique is listed among the top 30 countries with the highest TB incidence.

Economic inequality and malnutrition further fuel the problem. “Chronic poverty and inadequate nutrition are key drivers,” Hallstrom noted. Other factors include stigma, weak healthcare infrastructure, and delayed treatment. These challenges often prevent individuals from seeking timely care, according to health professionals. “Symptoms like weight loss, coughing, and night sweats are common, but people may misattribute them to allergies,” she added.

In Johannesburg, a patient shared her experience of delayed diagnosis. “I only found out about my TB after being hospitalized,” she said. “When I returned for results, I was told I had TB, but it wasn’t until then that I noticed symptoms like sweating, loss of appetite, and rapid weight loss.” Such stories underscore the need for better awareness and early detection.

Leaders in both countries are pushing for improved strategies. Deputy President Paul Mashatile highlighted progress in South Africa’s national TB program. “We’ve seen a steady reduction in new infections year after year,” he stated during a World TB Day event. “The program’s success lies in its ability to lower the rate of new cases annually.” Activists and officials are also ramping up community outreach to promote testing and treatment.

Community advocates play a vital role in spreading knowledge. Modesta Antonio, a 67-year-old leader in Mozambique, exemplifies this. Though lacking formal medical training, she became a key TB educator through a local initiative. Her work demonstrates how grassroots efforts can drive awareness. “Digital tools are also transforming the fight,” Hallstrom emphasized. Her organization uses the OneImpact app, a community-driven monitoring platform developed by the Stop TB Partnership, which operates in over 23 countries. This tool helps patients report discrimination and improves access to health information.

Experts stress that early diagnosis and consistent treatment are critical. “Weak health systems delay detection and weaken progress,” Hallstrom warned. Training more community communicators and integrating digital innovation are seen as essential steps to tackle the ongoing challenge.