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Siyayinqoba Beat It! Episode 19 -
Disseminated TB and HIV
This weeks episode of Siyayinqoba Beat It! 2006 we see how tuberculosis associated with HIV is South Africa's leading cause of death. We follow Busisiwe as she gets tested for disseminated TB, look at the links between TB and HIV and Dr Lindiwe Mvusi, Director of the Department Health National TB Programme, joins our support group to discuss any questions we may have regarding tuberculosis and how to make sure it is diagnosed correctly.
Shalom Ncala: Sanibonani, siyani amukela iqenjeni leSiyayinqoba Beat It!support group. Ingama lami ngingu Shalom Ncala. Eqenjeni loSiyayinqoba Beat It! sonke siphila kahle neHIV. Sanibonani nonke. Ninjani kodwa nahlanje. I viki ne viki siyahlangana ukuzo xoxisana ngezindaba ezithinta izimphilo zethu, ukusukhela khuma opportunistic infections, ukuya ekwaziseni abantu nge HIV, nokhusebenzisana namasonto. USiyayinqoba ngu hlelo lwakho lokhu phila kancono nge HIV.Uma uphila negciwane le HIV, noma unomlingani, ilunga lomdeni noma umngani ophila negciwane leHIVi siyayinqoba nge yakho. eNingizumu Afrika isifo sofuba esihambisane ne HIV, siyibangele ikhulu yekufa. Amapercent angaphezu ku55% eziguli aziphila ne HIV. Masiboneni ukuthi ababukheli bethu bathini baneyiphi imibuzo baqcondana ne TB. {IsiZulu} [Hello and welcome to the Siyayinqoba Beat It, support group. My name is Shalom Ncala. In the Siyayinqoba support group, we are all living positively with HIV. Welcome everyone. Each week we get together to discuss issues that affect our lives from opportunistic infections to disclosure and dealing with the church. Siyayinqoba is your guide to better living with HIV/AIDS. If you are living with HIV or you have a partner, a family member or a friend living with HIV, Siyayinqoba is for you. In the In South Africa, tuberculosis associated with HIV is the leading cause of death. More than 55% of patients with TB are living with HIV. Let’s see what questions our audience has about TB.]
QUESTION: What is disseminated TB and how do I get it?
Shalom Ncala: Ababa ningi abantu abaziya ukuthi ungathola iTB kwezinye izito zomuzimba, hayi kuphela emapheshini. Loluhlobo leTB lwaziwa ukuthi yiTB edlodlobele.Phecelezi disseminated TB., njengoba abantu bangazi ngeTB edlodlobele, esikhathini esiningi abaceli ukuthi bayihlolelwe lokhu kubanga ukuthi kungabonwa ukuthi banayo. Ukusisiza ukuthi siqonde lezizindaba izisemuqokha si amakela udoctor Lindiwe Mvusi uqondisi wom’nyango wezephilo wehlelo leTB kwezwe lonke. Siyakwamukela doctor, niyaphila.., nathi siyaphila. Sizoqala sibheke oyilunga lethu uBusisiwe Maqunga owaba nenkinga yokhu xilongwa yokuthi kuvezwe iTB edlodlobele. Masibhekeni isizathu ukuthi kungani. {IsiZulu} [Not many people know that you can get TB in other parts of the body, not only in the lungs. This form of TB is known as disseminated TB. Because people don’t know about disseminated TB, they often don’t ask to be tested for it and it goes undetected. To help us discuss this issue, we welcome Dr Lindiwe Mvusi, Director of the Department Health National TB Programme welcome doctor. How are you doing today? Our first episode follows our very own. Busi Maqungo, who struggled to be accurately diagnosed with disseminated TB. Let’s take a look to find out why.]
Cape Town, Western Cape, Busi is diagnosed with TB of the spine.
Busisiwe Maqungo: Ingxaki endinayo yiTB yomqolo. Ndandicinga ukuba zintlungu nje okwehla nakubani. Indizange krokrela nto ngokwe TB yemqolo nangona yayi enye yezinto bendifanele ndizikrokrele nje ngomntu ophila netshologwane yakha gawulawu. And ibekho for into engangonyaka, ndingayiqapheli ukuba yiyo. Kodwa ke kwinyanga ezithandathu ezedlulileyo kungona kengokhu, zaqala ukuqina izintlungu.{IsiXhosa} [I have disseminated TB. I thought it was ordinary pains that could be experienced by anyone. I never thought it could be TB of the spine, even though I should have, as a person living with HIV. I experienced these back pains for about a year, about six months ago, it became unbearable painful.]
Dr Robert Dunn: Molo Busi, so you understand what the problem is with your back, that you have tuberculosis of the bottom part of your spine, and that’s what’s causing you the pain that you have.
Busisiwe Maqungo: Uze uqwalisele ukuthi odoctor aba ngo doctor abazimeleyo, ndandingayi khubogqirha basezikliniki zoluntu, okanye ezibhedlela zoluntu. Kuyoyonke lentoyeyo ukumover from ugqirha khomunye to khomunye ugqirha azange kubekhona improvement. And kekho ugqirha oyewayi qwalisela intobana yintoni kanye kanye.{IsiXhosa} [Bear in mind that I went to private sector doctors and not doctors from the public sector. After consulting with so many doctors, there was still no improvement. Not one doctor could diagnose what the cause of my backache was.]
Dr Robert Dunn, Spinal and Orthapaedic Surgeon: The reason you’ve got the TB is because of the HIV, okay? The HIV makes your body weaker, it makes your ability to get rid of infections worse, so you’re more vulnerable to get the infection. The germ is in the community, everybody is breathing this germ out. Most people get it in the lungs, but about 1% of people get it in the spine, and you’re one of those. Okay, we need to do an MRI scan, a magnetic imaging scan, which will give us a much clearer picture of what’s going on inside. You can see the details of the pus of the nerves, of the muscles, which will show me exactly what needs to be done then we need to get a biopsy, and a biopsy is a needle that we stick into your body to suck out some of that pus and send it to a laboratory to see that it is really TB. Cos sometimes it could be other conditions that cause it, you can have a cancer, or another type of infection.
Busisiwe Maqungo: Ibiopsy was enye yona ezinye izitho izibuntlungu endingava ubuntlungu emuhlabeni. Nangona ndilubeka iqanduva khogqirha abangazange bayicinge okanye bayikrokrele itobane kungayenzeka ukuba yiTB lena but on the other hand ndiyacinga ukuba nami ndayenza iphazamo yobandingathi ekusukheni, nje zisukha ndiye kugqirha osebenza ngeHIV. {IsiXhosa} [The biopsy was one of the most painful things I ever experienced in my life. Although I blame the doctors for not suspecting that my paints were caused by TB of the spine, I also think it was my mistake for not consulting an HIV specialist immediately.]
Dr Robert Dunn: The drugs we use for TB. There’s a chance that the drugs need to be changed for you. Because of the HIV, sometimes we need to use slightly different drugs, because the TB you get may not be sensitive to those drugs. So the aim is always, start the TB drugs, see how effective they are, maybe add retrovirals if necessary.
Busisiwe Maqungo: Ngoba ndisezibhedlela nda ndandixokhola nomhlobo ndandisithi kuye iHIV okwesibini ebobini bami has made ir real intoyokuba ndiphila netshologwane yakhagwawulayo. Because okhokuqala ukuba real ukukhuqala kunge ngelexesha ndandi songa umntanami owaye waswelekha ukugqibeleni wayaneHIV. But emveni khokho ndaye sendiphila ngokukhulekileyo ne HIV lento leyo yathi siba, not that bendithi iHIV im’kile khum’ but you know the positive living part of it for ixesha elinde. Then kuye kwafika nale TB ngokhu, kwangona yo! Kanene ndine HIV. {IsiXhosa} [I told a friend in hospital that for the second time in my life HIV has made it real that I am living with HIV. The first time was when I was caring for my baby who died because of HIV. But after that, since I’ve been living positively with HIV, it faded from my mind. Not that I thought I no longer have HIV, but the fact that I’ve been living positively for such a long time. Then, now that I have TB, I had to come to the self realisation that I’ve HIV positive.]
Support group
Lihle Dlamini : I immune yethu siyichecka nge CD4 count ukuze sibone ukuthi sesi-ready uku-starter amaARVs. Enye into engifuna ukuyifind out since ukuTB treatment and its abvious ukuthi ukuAIDS stage stage four ngoba unedisseminated TB. Udoctor wakho uthini ngoku qala usebenzisa amaARVs?{IsiZulu} [Most of us living with HIV need to monitor our CD4 count to know when we need to start ARVs.] But when it’s a different case, you look healthy and are only complaining about back pain, it’s actually TB of the spine. [Another thing I would like to know is, since you are on TB treatment and its obvious that you are on the AIDS stage, which is stage 4, because you have disseminated TB. What has your doctor said about starting ARVs?]
Busisiwe Maqungo: Kulevekhi ephelileyo ndaya ndayobona ugqirha wami wase MSF malunga nento yama ARVs. Okukhuqala isizathu sokuba ndicinge ukuba ndingene kuARVs njengoba usitsho iTB engaphadle kwamaphaphu yenye ye AIDS defining illnesses. Njengoba isho iprotocal uzoba ku ARVs if iCD4 count yakho ingi 200 ngaphandle yokhuba upresenter iAIDS defining illness. {IsiXhosa} [It was only last week that I went to my MSF doctor regarding ARVs. Firstly, the reason I think I should start taking ARVs is because disseminated TB is one of the AIDS defining illnesses. The protocol states that you should be on ARVs, when your CD4 count is 200 or less, or if you have an AIDS defining illness.]
Lihle Dlamini: If I have these pains, and I’m now hearing Busi’s story, and I’m not working and cannot afford to go to a private hospital where I have to pay a lot of money, it easy for me ngiya kwi public hospital ngibacele ukuthi kande sikhuluma ngalokuthi and I need you to check iTB kumina {IsiZulu} [is it easy for me to go to a public hospital and tell them these are my symptoms and I need you to check every form of the TB,] how easy is that?
Dr Lindiwe Mvusi, Department of Health: I-TB yespine amatambo kungabanakho ukumazima ukuyi diagnosa kodwa mawuya eclinic definitely ayikho idlela yokuyi diagnosa, kodwa izibhedlela akhona ama-X-rays, and then ke singabona ukuthi ikhona inkinga. And then amanye amatest angayeziwa like I njengoba ukhuluma nge plural effusion la uvele ukhiphe lamazi ala esifubeni, athunyelwe elab ayotestwa, neyoyenza ibiopsy nokuyenza masithi mhambe ilimbar puncture lawo angayeziwa in any hospital., la kuno dokotela khona, ngoba kundingekha umuntu oyaziyo ukufaka inaliti kahle the fanele siyenze sure ukuthi ngumuntu okujwayelo ukuyenza lokho. Kodwa hamatest angayenziwa kuze ukutholakhale i-diagnosis early. {IsiZulu} [TB of the spine can be difficult to diagnose. Clinics don’t have the right equipment to diagnose it. But all hospitals have x-rays, they can see if there’s anything wrong. There are other tests that can be done, like a plural effusion, when fluid is drawn out of the chest and sent to a lab to be tested. A biopsy and lumbar puncture can also be done at any hospital by a doctor with the necessary experience. Those are the tests that can be done for early diagnosis.]
Vuyani Jacobs: Busi went to many doctors with the same issues. Now there’s no filing, the filing’s all over the world. Now you can not diagnose quite better I think that should be part of our positive living, that means we need to have a history of our illness, we need to know exactly when did we get ill, when did we get sweating, when did we get coughing so you know that we are suspecting around there, because Busi is really lucky , I have to say is really lucky because just imagine how many people have died out of having that kind of thing because, she was diagnosed in Groote Schuur, which has you say its not available else where I’m sure if it was detected early it could have been treated not in eighteen months.
Fanie De Villiers: What can we do as patients out there to assist the healthcare professionals to diagnose TB much quicker?
Dr Lindiwe Mvusi: I think it starts off with awareness. You must know what is happening so that, to you, and then you must know how to detect when you have a particular illness. Fanele u wazi ama-symptoms and the mase uwazi ama-symptons.{IsiZulu} [By that I mean you must know the symptoms, once you know the symptoms] then you are able to present yourself to a facility whether is a clinic and say, ‘Look, I’ve got this and that’ and probably if you can even go on and say, ‘I think I probably have this’. There’s nothing wrong with that. And then tests will be done, obviously, to prove or disprove what you may think you have. Even if you say, ‘Yes, I have this and this, I probably have this and this’. If the tests come back and prove that you don’t, you probably do not have it. But should you, at any stage, say that you are not feeling better, you have the right to go back to that clinic or hospital and say, ‘I’m not feeling better, can I have access to more tests’.
Vuyani Jacobs: Mina, na uBusi anemqolo ubuntlungu ngolohlobo, neleTB anayo ungathi uneAIDS uqobo, so leyento ithetha ukuba ufanele aqale ipilisi azi aithiwe zianti-retrovirals. So ndifuna ukubuza kuwe is it true ukuba unefull-blown AIDS? {IsiXhosa} Does that fact that Busi has TB means she has full blown AIDS, which means she has to start taking ARVs? Is it true that she now has full-blown AIDS?
Dr Lindiwe Mvusi: Extra Pulmonary TB kumuntu o-HIV positive is an AIDS defining illness that is clear. [Extra pulmonary TB is an AIDS defining illness to someone living with HIV.] But now, Busi did actually allude to the fact that she is supposed to start on anti-retrovirals. But then I think there are a number of issues to be considered for anyone ofanele ukuthi amutreater because umenshinile ukuba okakho ready [who is going to treat her, because she mentioned the fact that she is not ready.] And that is very critical on starting anti-retrovirals. Your readiness around it and then probably the other concern would be for clinicians would be to drug interactions, the side effects. Ngakho ke you need to consider ukuthi isimo sakhe sime kanjani at the time ubona and decide ukuba ufuna ukum’qala ngazo zonke at the sametime, okanye uzamuqala ngeTB because yiTB serious azengayo nkoku and then umutreater leyo TB anayo ube uqubekha umu-assesser umunikhe lachance ukuba aresponder. Uma at any stage uthi sekha ready ukuziqala then angaziqala. {IsiZulu} [So we need to consider her current state of health, and then decide if you’re going to start her on both treatments or just the TB treatment, because her main problem now is TB. While treating the TB, you assess her and give her a chance to respond. It at any stage she says she’s ready to start] ARVs, she can. But otherwise, it won’t do any harm to wait in a person who is well.
Vuyani Jacobs: It is dangerous nxa athi akakho [if she says she’s not] ready. Which means, the medications for TB, 18 months, it’s like taking ARVs, because it’s everyday. Which means nxa angakho ready for ARVs there is a possibility ukuthi akazoba adherent kwezi zeTB? {IsiXhosa} [if she is not ready to take ARVs, chances are that she won’t be adherent to TB] treatment.
Dr Lindiwe Mvusi: I-TB at least iyalapheka, uyachonda, ayifani ne-HIV. And wena you should be more encourage ukuba uyithathe le treatment everyday. On the other hand Vuyani mina I would have taken it ukuba ke ushilo ukuba akakho ready for anti-retrovirals uyazazi i-weakness zakhe.{IsiZulu} [Unlike HIV, TB can be cured. You should be more encouraged to take this treatment everyday on the other hand Vuyani me I would have taken it that she said that she is not yet ready to takes ARVs, as she knows her own weaknesses.]
Vuyani Jacobs: Uzafa kodwa. {IsiXhosa} [She will die for really.]
Dr Lindiwe Mvusi: Le yeTB is actually going to be a test for uBusi ukuba kanye kanye ndizazi lingela na ianti-retrovirals. {IsiZulu} [The TB treatment should be a test for Busi. To see if she can be adherent to ARVs.]
Shalom Ncala: Sizo khuluma futhi ne-TB edlodlobele ne-HIV emva kwekhefu. Siyabuya. {IsiZulu} [We talk more about disseminated TB and HIV after the break. We’ll be right back.]
Shalom Ncala: M’bukeli siyakwemukhela futhi kuSiyayinqoba Beat It! Uhlelo lawonke umuntu ongenwe no thithekayo yiHIV. Namhlanje sikhuluma ngeTB edlodlobele no doctor Mvusi. Iqembu leSiyayinqoba livakashele um’tholaphilo wase Phomolong e Free State, lapho abasebenzi bezwelapho bafundisiwe ukuhlanganisa uhlelo labo leHIV ne TB. Masibhekheni. {IsiZulu} [Welcome back to the Siyayinqoba Beat It! support group – the programme for everyone infected and affected by HIV. Today we are talking about disseminated TB with Dr Mvusi. For the next insert the Siyayinqoba team visited Phomolong clinic in the Free State, where the medical staff has been trained to integrate their approach to HIV and TB. Let’s take a look.]
Welkom, Free State: The link between HIV and TB
Leona Smith, TB Coordinator: [My name is Leona Smith. I’m the district TB coordinator for Letweleputswa. We are responsible for all the district hospitals including all the clinics. There was a long overdue need for us to work together with HIV programmes. In 2003 we were invited by PASLA of the University of Cape Town, but it was only TB coordinators that went to Cape Town. There we received training and learning material which included very little HIV/ AIDS information. As a result our provincial office requested more HIV/AIDS information to be included in the training that we received.] {Afrikaans}
Makhala Marumo, HIV/AIDS Coordinator: [We knew what was expected from the workers at the ARV clinics. So we shared the training that we had received with the clinics. We taught the other nursing sisters about STIs, HIV/AIDS and TB and the learning material from PALSA has helped us a lot.]{Sesotho}
Sister Nurse: [I’m fine thank you.] {Sesotho}
Woman: [Sister, I have been to counselling.] {Sesotho}
Sister Nurse: [What were you counselled for?] {Sesotho}
Woman: [For HIV/AIDS] {Sesotho}
Sister Nurse: [In other words, you want to know your HIV status.] {Sesotho}
Makhala Marumo: [Because HIV attacks the immune system, a person with HIV is more prone to TB. So we are expecting numbers of people numbers of people being HIV positive who may develop TB so that is why we need to work together with all programmes. Another things is TB, some of the signs in the TB patient, the symptoms in TB patients will show us the symptoms of HIV.] {Sesotho}
Leona Smith: All our TB patients must be referred for counselling, and all our HIV positive patients must be screened for TB.
Sister Nurse: [Go to a private space with these bottles. Put your sputum inside. When you’re done, close the bottle and bring it back to me. The results will be ready in three to four days. Come back then to find out what your CD4 count and TB status is.] {Sesotho}
Makhala Marumo, HIV/AIDS Co-ordinator: [We also make sure that the lay counsellors know about ARVs that they were in a group that was taught TB and everything that the nurses were trained in. The nurses also do drug readiness and adherence sessions to prepare people for their treatment.] {Sesotho}
Support group
Shalom Ncala: Doctor bengi cela ukwazi, emva kwe-insert esicenda ukuyibona kuhlanganiswe amaTB patients and HIV patients is that putting us at risk getting infected ngeTB as HIV patients, thina ngokwethu na {IsiZuLu} [After watching the insert, will mixing HIV patients and TB patients put the HIV patients at risk of contracting TB? What is the set up really, is it an ideally situation or we should keep them separate.]
Dr Lindiwe Mvusi: I would go for ukuthi abathu bahlale endaweni eyodwa, ngoba nalento yokuthi sihlukanisa abantu ekliniki ibangela ukuthi si reinforce i-stigma. And ke but i-problem asiyibanayo yikuthi umangabe uyaelkinike especially amakliniki wethu amacane and uthole ukuthi nespace sokulinda sicane,ugwele abantu into esingayiyenza yikuthi sense sure ukuthu lezozindawo ezukulindela emakliniki zi safe… there’s proper ventilation. If khusho ukuthi akuna enough space then kunga creatwa indawo at least evulekhile ukuthi abantu bakwazi ukulinda khona. {IsiZulu} I would go for having the patients all in one place because separating them reinforces stigma. But the problem we’re facing at the moment is that if you go to a clinic, especially those small clinics where the waiting area is limited, what we can do is to make sure that the waiting areas are safe… There’s proper ventilation. If there is not enough space, then it should be created.
Lihle Dlamini: Ngiyayithanda lento engiyibona ku insert i-setting ye environment. [I like what I saw in the insert the setting of the environment] whereby healthcare workers of HIV and TB sharing information. And they can actually refer TB patients to VCT. Ikliniki yami yase Lamontville, there is a VCT site and also yi-TB department and they actually refer TB patients to VCT and kuya dependa kuloyo muntu ukuthi uyafuna ukuya ku-VCT. {IsiZulu} [My clinic in Lamontville is a VCT site at and they also have TB department and they actually refer TB patients to VCT and it depends on whether the person wants to go for VCT.] But the actually recommend that the person goes for an HIV test as well because we know that TB is an opportunistic infection.
Shalom Ncala: Amadoctor ukungabe ba come across i-situation ye TB, kubaluleke kangakanani ukuthi ba-offerer umuntu ukuthi a-teste for i-HIV?{IsiZulu} [When doctors come across a TB situation, how important is it for them to recommend an HIV test?] Because there is a close link as you know to HIV, of TB to HIV.
Dr Lindiwe Mvusi: Siyazi ukuthi yes if umuntu anayo i-TB usengaba nechance ukuthi abaHIV and abaye ngisho noma umuexamisha umone ukuthi ikhona lephawo sikhona lakuye ukuthi kungayenzakala ukuthi u-HIV positive. Ngakho loyo muntu fanele siyenze sure ukuthi noma angazo vuma uku-testa ngalelo langa at least siyakuluma naye simutshele ukuthi chances ukuthi unayo i-HIV sicela ukuthi teste so that uzosazi i-status sakho u-accesse proper care. And enye into isiyiyenzayo wonke umuntu one-TB uya offerishwa i-counselling for HIV so at least noma angazo uku-testa at some stage asaqhubeka edla itreatment uzoyicabanga lento abuye makase ready abuye azo-testa ukuze nomangabe sesiyiqenda i-treatment yakhe sikwazi ukuthi a accesser i-care ye-HIV. {IsiZulu} [We know that if a person has TB, there’s a chance that they may also be HIV positive. When you examine some of them, you see signs of possible HIV infection. Even though that person might not agree to test on that day. We must at least tell them that they might be HIV positive. They need to test for HIV to know their status and get access to proper care. We also offer HIV counselling to everyone who has TB so that they can come at later stage to test for HIV, so that after finishing the TB treatment they can access care for HIV.]
Thami Mthembu: What is the protocol for people that are on TB treatment, Ukuthi baqala nini ukuthi baqala ama anti-retrivirals treatment drugs? {IsiZulu} [when do you they start taking ARVs.]
Dr Lindiwe Mvusi: Currently with the protocol, for example ngizo khuluma nge pulmonary TB not nge extra pulmonary TB. [I will talk about pulmonary TB, not extra pulmonary TB.] If you’re CD4 count is still more than 200 then you just take treatment and you are monitored and if you complete the treatment still with the high CD4 count obviously its fine then you are referred to an ART clinic. Kodwa masibona ukuthi iCD4 count ko 200 between 200 and a 100 and then lapho ke sizokuqala bge TB treatment and then maybe after, within a period of two months uqalekwe ngama anti-retrovirals.{IsiZulu} [If the CD4 count is between 200 and 100 we start by giving them TB treatment and then within a period of two months, we start the patients on ARVs.]
Shalom Ncala: Sizo khuluma futhi nge-HIV kanye ne-TB edlodlobele. Sizobuya emva kwekhefu. Siyabuya.{IsiZulu} [We talk more about disseminated TB and HIV after the break. We’ll be right back.]
Shalom Ncala: M’bukeli siyakwemukhela iqenjeni leSiyayinqoba Beat It! Uhlelo lawonke umuntu ongenwe no thithekayo yiHIV. Namhlanje besikhuluma nge-TB edlodlobele ne-HIV. Sibonga izivakhashi iziqavile zethu u-doctor Mvusi kanye noBusi ngokuthi asixocele indaba yakhe. Namhalnje sifunde ukuthi i-TB ye dlodlobele iyalapheka kanti laba abaphila ne HIV kusemxokha baye emthola philo useduze nabo ukuyohlolelwa i-TB njalo. Buza udokotela wakho ngo lawzi oluongeziwe oluphathane nge TB edlodlobele ngoba lokhu kusemqokha iphilweni yakho. Sibonga zonke izincwadi enizithumele futhi sicela ukuthi nihlale nizithumela njalo. Siyayijabulela imibona kanye nezibuzo zenu. Ngakho ke icela ukuthi nissibhalele kumuninigwana engezansi. Hlanganela nathi futhi eqenjeni lesiyayinqoba Beat It! Kuze kube yileso sikhathi hlala unephilo futhi uphija kahle. Salani kahle. {IsiZulu} [Welcome back to the Siyayinqoba Beat It! support group. The programme for everyone infected and affected by HIV. Today we have been talking about disseminated TB and HIV. Thanks to our guests, Dr Mvusi and Busi for sharing her story with us. Today we’ve learnt that disseminated TB is curable and that for those who are living with HIV, its important to go to your nearest clinic for regular TB checks. Ask your doctor for more information about disseminated TB because this is vital to your health. Thanks for all the letters you’ve sent. We value your comments, suggestion and questions, so please contact us on the details below. Join us again next week in the Siyayinqoba Beat It! support group. Until then, Stay healthy, stay positive. Goodbye.]
Question: Can TB occur outside of the lungs?
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