The Misconception About TB in South Africa: A Closer Look

“If you are South African, you have TB, latent TB at best… actual full-blown TB, worst case.” This statement, while alarming, is a common misconception. Let’s go into the data and statistics to understand the real situation surrounding Tuberculosis (TB) in South Africa.

1. Prevalence of TB in South Africa

According to the World Health Organization (WHO), in 2020, South Africa was among the top 20 countries with the highest TB burden. However, this does not mean every South African has TB.

  • In 2020, the incidence rate of TB in South Africa was approximately 615 cases per 100,000 population. This means that out of every 100,000 South Africans, 615 were newly diagnosed with TB that year.
  • To put it in perspective, this is less than 1% of the population.

2. Latent TB vs. Active TB

It’s essential to differentiate between latent TB and active TB:

  • Latent TB: A person with latent TB is infected with the TB bacteria but does not show symptoms and cannot transmit the disease. It’s estimated that about one-third of the world’s population has latent TB.
  • Active TB: This is the contagious form of the disease, where the person shows symptoms and can spread the bacteria.

While a significant portion of the South African population might have latent TB, only a fraction of those will develop active TB. The risk of latent TB progressing to active TB is about 5-10% over a lifetime.

3. Factors Contributing to TB Prevalence

Several factors contribute to the high prevalence of TB in South Africa:

  • HIV Co-infection: South Africa has a high HIV prevalence, and HIV-positive individuals are more susceptible to TB due to a weakened immune system. In 2020, approximately 58% of TB patients were also HIV-positive.
  • Socio-economic factors: Overcrowding, malnutrition, and limited access to healthcare can increase the risk of TB transmission and progression from latent to active TB.
  • Delayed diagnosis: Late or missed diagnosis can lead to prolonged periods of infectiousness, increasing the risk of transmission.

4. Efforts to Combat TB

The South African government, in collaboration with international organizations, has been working diligently to combat TB:

  • TB screening: Increased efforts in screening, especially in high-risk populations, have been implemented.
  • Treatment: The Directly Observed Treatment, Short-course (DOTS) strategy has been adopted to ensure patients complete their treatment.
  • HIV and TB co-treatment: Integrated services for HIV and TB have been scaled up to tackle the dual epidemic.


While TB remains a significant public health challenge in South Africa, it’s misleading to assume that every South African has the disease. Awareness, early diagnosis, and treatment are crucial in the fight against TB. As global citizens, it’s our responsibility to be informed and avoid perpetuating misconceptions.