IsiZulu - Treatment Action Campaign

Magazine of the Treatment Action Campaign 

treatment 

September 2011 

I-TB ingelashwa! 

Iminyaka emine yokulwa ne-TB: U-Xoliswa 

Harmans uxoxa indaba yakhe emangalisayo 

I-TB yambuliwe: Incwadi okulula 

ukuyiqonda ngesayensi ye-TB 

Umbuzo wokuvalelwa ngenxa 

yesifo: Inqubomgomo entsha 

kungenzeka ishintshe yonke into

Umhleli: Marcus Low 

Umhleli Wezithombe: Andrea Zeelie 

Umhleli Wekhophi: Cathy Goudie 

Abafake isandla: Nathan Geffen, Mary-Jane 

Matsolo, Catherine Tomlinson, Agnieszka Wlodarski, 

Elizabeth Mills, Claire Wingfield, Elizabeth Vale, 

Luckyboy Nkhondwane 

Isithombe sekhava: Chelsea Maclachlan 

Izithombe: Chelsea Maclachlan, Adam Malapa, Jose 

Cendon, Bruno De Kock, Gawain Kripke, Mariella 

Furrer, Elizabeth Mills, Travel Aficionado, Elizabeth 

Vale, Luckyboy Mkhondwane ne-Bookslive.co.za. 

Umfanekiso osekhasini le-13 ngu-Brice Reignier. 

Umfanekiso osekhasini lama-27 ngu-Sizwe Nguqe. 

Sibonga u-Xoliswa Harmans ngokukhethekile 

mgokuxoxa indaba yakhe, ku- Claire Wingfield 

we-Treatment Action Group, ku-Alex Müller, Nathan 

Geffen no-Kay Kim bonke abafake isandla ku- 

TBOnline.info. 

Ukuhambisa: Market Insertion Bureau 

Ukuhlelwa kwebhuku: Designs4development, www. 

d4d.co.za 

Ukuphrinta: CTP Book Printers 

Ukuhumusha: Bohle Conference and Language 

Services 

I-TAC izinikele ekuhlinzekeni abantu abane-HIV, 

imindeni yabo kanye nabanikezeli bokunakekela 

ulwazi olungenaphutha ngemithi esindisa impilo 

kanye nokwelashwa. I-TAC kanye nabaholi 

bayo bazimele abekho embonini eyenza imithi 

yezokwelapha kanjalo nezimboni zemithi yemvelo 

kanye nehlukile futhi ayinatshisekelo yemali kuzo. 

Leli hlelo le-Equal Treatment lixhaswe ngezimali yi- 

Global Fund to Fight AIDS, Tuberculosis and Malaria, 

kanye ne-Oxfam Australia. 

Leli phephabhuku liyatholakala futhi ngesiTsonga, 

isiXhosa nesiNgisi. 

Ungakhiphela la mahlelo e-Equal Treatment kanye 

nawangaphambilini kuleli kheli: www.tac.org.za/ 

community/equaltreatment/ 

Equal Treatment is 

published by the Treatment 

Action Campaign. 

Ikheli Leposi: PO Box 2069, Cape Town 8001 

Ikheli Lendawo: Westminster House, 122 Longmarket 

Street, 3rd Floor, Cape Town 8000 

Ucingo: 0861 END HIV 

Ifeksi: +27 21 422 1720 

Iwebhusayithi: www.tac.org.za 

Amahhovisi Esifunda e-TAC 

Khayelitsha District: 021 364 5489 

Ekurhuleni District: 011 873 4130 

Lusikisiki District: 039 253 1951 

Pietermaritzburg District: 033 394 0845 

Gert Sibande District: 017 811 5085 

Mopani District: 015 307 3381 

2 

Okuqukethwe 

amakhasi 2–5 



Ihlelo 40 – Septhemba 2011 

isiZulu 

Indaba ka-Xoliswa nomlando we-TB 

UXoliswa Harmans wazabalaza ne-TB 

iminyaka emine. Indaba yakhe emangazayo 

siyilandela ngomlando omfishane wokuthi 

lesi sifo sesiyicekele phansi kangakanani 

imiphakathi amakhulukhulu eminyaka kanye 

nenqubekela phambili ehamba kancane 

esesiyenzile ekulweni naso. 

Isayensi ye-TB 

Isayensi ye-TB akufanele ukuthi yethuse. 

Encwadini yethu okulula ukuyiqonda 

ye-sayensi ye-TB sembula yonke 

into kusukela ekumelaneni nemithi 

ukuya kumenenjayithisi ye-TB. Futhi, 

ungaphuthelwa yiphosta yethu yemithi 

ye-TB kanye nemiphumela yayo emibi, noma 

uhambo lukaMandla noSipho esikhaleni 

esisekhasini 13. 

Ukuvalelwa ngenxa yesifo, okusha 

okuvelile kanye nohlelo lwe-SACTWU 

Ukuhlukaniswa ngempoqo kweziguli ze-DR- 

TB kwenza izihloko eziphambili eminyakeni 

embalwa eyedlule. I-Equal Treatment 

iphenya inqubomgomo yokunakekela entsha 

esisatshalaliswe nakwezinye izindawo 

enikeza ezinye izixazululo. Emva kwalokho 

sikunika ulwazi olusha ngokuhlolwa kwe-TB 

okusha okuthokozisayo futhi sibheke 

phambili emithini ye-TB yesikhathi esizayo. 

Siye sathola futhi ngalokho enye inyunyana 

yezohwebo ekwenzayo ukusiza abasebenzi 

ukuthi bahlale bephilile. Ekugcineni, 

ekhasini 28 sikulethela izindaba zakamuva 

zamagatsha e-TAC. Thola ukuthi amalungu 

e-TAC ayifundisa kanjani intsha esencane 

nge-HIV nezifo ezithathelwana ngocansi 

ama-STI.

Isithombe yi-bookslive.co.za 

Umhlaba we-TB udinga intukuthelo 

nobushoshovu 

“Isifo sinqotshiwe.” 

La mazwi ashiwo ngonyaka ka-1962 ngumsebenzi we- 

International Union Against TB. Babenephutha. Kodwa 

Inyunyana yayinethemba elikhulu ngenxa yokuthi imithi elwa 

ne-TB ngempumelelo yayitholakele. Isifo esibulalayo esase 

sibulele abantu emhlabeni wonke iminyaka eyizinkulungwane 

eziyishumi, i-TB yayisilapheka. EYurophu naseNyakatho 

Melika, ukufa nge-TB kwehla ngokumangalisayo. 

Kamuva esiganyini sekhulunyaka, cishe isigidi nohhafu 

sabantu sabulawa yi-TB unyaka ngamunye. ENingizimu Afrika, 

inamba yokufa nge-TB eyarekhodwa yaphindwa kathathu 

phakathi kuka-1997 no-2005. Isifo sisekude kabi nokuthi 

sinqotshwe. Pho kungani izinto zahamba kabi? Kunzima 

ukwazi ngokuqinisekileyo, kodwa nazi ezinye zezimpendulo 

ezinokuba khona: 

Okokuqala, umzamo owafakwa ekuqedeni i-TB emazweni 

acebile awuzange ukopishwe emazweni ampofu. Okwesibili, 

i-TB yaphinde yabuya nobhubhane lwe-AIDS. Okwesithathu, 

amadolobhakazi amakhulu emazweni asathuthuka 

anamadolobhana ayizindlwana lapho abantu abangondlekile 

bephila ezimeni ezimbi, nezinabantu abaningi ngokweqile. 

Lokhu kuvumela ukuthi i-TB iphile kahle. Okwesine, izinhlelo 

zezempilo emazweni ampofu awakwazi ukumelana nezinamba 

ezinkulu zezimo ze-TB. 

Ngaphezu kwalokhu, eshumini leminyaka eledlule umhlaba 

ubone ukukhula kwe-TB engazweli emithini (DR-TB). Manje 

abantu abaningi abaxilongwe ngesifo kungaba singelashwa 

kuphela emva kokwelashwa ngemithi kwesikhathi eside 

ngokweqile nokunzima, noma abakwazi ukwelapheka nhlobo. 

Yini okudinga ukwenziwa ukuze 

kunqotshwe i-TB? 

1. Sidinga imithi engcono 

Akukaze kube nokuvunywa kwekilasi lemithi emisha ye-TB 

emashumini eminyaka. Kodwa manje sekunenqubekela 

phambili. Umuthi omusha othokozisayo kakhulu i-TMC207, 

owenziwa inkampani eyenza imithi i-Tibotec. Izinhlolo 

zokwelashwa ezincane zikhombisa ukuthi welapha iziguli 

ze-TB ezingazweli emithini eminingi ngokushesha futhi 

ubukeka unemiphumela emibi kakhulu embalwa. Kodwa 

eminyakeni eyisikhombisa emva kokutholakala kwe-TMC207 

kusengekacaci ukuthi izogunyazelwa nini ukusebenza. 

I-TB akusiso isifo esinenzuzo, imboni eyenza imithi ihamba 

kancane kakhulu emithini ye-TB. 

Umbiko womhleli 

Enye inkinga enkulu ukuthi imithi ye-DR-TB iyabiza kakhulu 

futhi empeleni aseyabiza kakhulu eshumini leminyaka 

eledlule. 

2. Sidinga ukuxilongwa okungcono 

Kaningi kungathatha amasonto ayisithupha ukuxilonga 

i-TB futhi ngisho kajana ukuxilonga i-DR-TB. Manje 

kunokuxilongwa okusha kwe-TB, umshini i-GeneXpert, 

oxilonga i-TB ngokungenaphutha emahoreni amabili. Kusiza 

futhi ukukhomba iziguli ezingazweli emuthini. INingizimu 

Afrika ithenge le mishini eminingana, kodwa kudingeka 

ukuthi sibe nowodwa kuyona yonke imitholampilo ye-TB 

enogesi. Kodwa-ke, ukuhlola nge-GeneXpert ngakunye kubiza 

ngaphezu kuka-R100. Kudingeka ukuthi sifake ingcindezi 

kumakhi, u-Cepheid, ukuthi ehlise inani lentengo. 

3. Sidinga ukuthi uhlelo lwethu lwezempilo lusebenze 

kangcono 

Imitholampilo ye-TB idinga ukunikezelwa kwemithi 

okuthembekile. Ukunikezela okuthembekile kuholela 

ekumelaneni nomuthi. Imitholampilo kufanele futhi ukuthi 

ibe nokulawulwa kwesifo okufanele. Abantu akufanele ukuthi 

bathole i-TB uma beya emtholampilo! Futhi, abasebenzi 

bezempilo kufanele balandelele umkhondo wabantu 

abaxhumana nabantu abane-TB bese ubacela ukuthi 

bahlungelwe i-TB. 

4. Ukuvinjelwa kwe-TB 

Ukwelashwa ngezidambisigciwane kunciphisa ingozi ye-TB. 

Kunobufakazi obukhulayo, abukapheleli, ukuthi uma ufaka 

umuntu one-HIV ekwelashweni, umphakathi uyasizakala 

ngezinga eliphansana lezimo ze-TB ezintsha. 

5. Umhlaba we-TB udinga ukushukunyiswa 

Ingqungquthela yomhlaba elandelayo ye-TB izobanjelwa, 

futhi eFransi. Ngaphandle kweKapa, lapho eyake yabanjelwa 

khona eminyakeni eminingana eyadlula kudala, ayikabanjelwa 

ezindaweni ezinobunzima be-TB obuphezulu. Ngamanye 

amazwi, kwenzeka kude namakhaya eziguli ezine-TB 

nakodokotela be-TB abanolwazi kakhulu kanye nonesi. 

Ubushoshovu obuguquguqukayo babo bobabili iziguli 

kanye nabasebenzi bezempilo esibabonile ekuphenduleni 

ezidingweni ze-HIV okufanele ithunyelwe emhlabeni we-TB. 

Uma kufanele sithole imithi engcono, izinhlelo zokuxilonga 

kanye nezempilo ze-TB, sidinga umzabalazo omkhudlwana 

kanye nentukuthelo enkudlwana! 

nguNathan Geffen, usikhwama we-TAC kanye nomhleli we- 

TBOnline.info 

1

I-TB NGALESO 

SIKHATHI NAMANJE 

UMZABALAZO 

WAMI 

WEMINYAKA 

EMINE 

2 

Iminyaka emine u-Xoliswa 

Harmans wazabalaza 

nesifo sofuba i-TB kanye 

ne-TB engazweli emithini 

ye-TB . Uxoxela u-Mary- 

Jane Matsolo indaba yakhe 

emangazayo. 

Isithombe ngu-Chelsea Maclachlan.

Emva kwemizamo eminingi ehlulekile, ngagcina 

ngihlangene no-Xolisa Harmans endlini encane 

yokuhlanganela emahhovisi e-Médecins Sans Frontières 

eKhayelitsha. Uma umbona okukuqala ubungeke 

uqagele ukuthi lo muntu wesifazane ozikhulumelayo 

oneminyaka engama-37 uke waba nomzabalazo omude 

kangaka wokuba ne-TB engazweli emithini eminingi 

(MDR-TB). 

Wazalelwa e-Queenstown futhi uyilungu lesonto loFakazi 

BakaJehova, manje usehlala ku-Site C, eKhayelitsha. 

Evaleleke kuleliya hhovisi elincane u-Xoliswa 

uyangilandisa ngale minyaka emine yomzabalazo 

akawubekezelela ne-MDR-TB kanye ne-XDR-TB 

(i-TB emelana nomuthi kakhulu). Akusiso isithombe 

esiqhakazile. 

UXoliswa waxilongwa okokuqala i-TB ngonyaka ka-2006 

lapho eqala ukuba nezimpawu ezifana nokuncipha 

emzimbeni, ukukhwehlela, kanye nokujuluka ebusuku. 

Esimeni sakhe i-TB kwakuyisifo esibona intuba njengoba 

wayene-HIV futhi. Izinyanga eziyisithupha u-Xoliswa 

waphuza imithi yakhe ye-TB, kodwa ezinyangeni 

ezintathu ngemuva kokuba eyiqedile wayesalokhu 

engakaphili. Ihlombe lakhe langakwesokunxele 

lalivuvukele futhi kwakunesigaxa ekhwapheni lakhe. 

Wayesalokhu encipha emzimbeni. 

Lapho u-Xoliswa ephindela eyokwenza okunye 

ukuhlolwa kwe-TB imiphumela yabuya ingenayo i-TB. 

Umndeni wakhe wanquma ukumthatha umphindisele 

e-Queenstown lapho ababezokwazi ukumnakekela 

khona. Ngesikhathi ese-Queenstowwn u-Xoliswa 

walaliswa esibhedlela e-Frere ukuze odokotela bamhlinze 

isigaxa esisekhwapheni lakhe, okwashiya imbobo 

enkulu. ngaleso sikhathi, ihlombe lakhe laliqhubeka 

nokuvuvukala. 

Emva kokuhlinzwa u-Xoliswa kwakudingeka ukuthi 

athole imbangela yokuvuvukala kwakhe. Wabuyela 

eKapa wayeseya eSibhedlela i-Groote Schuur lapho 

akaphinde waxilongwa khona i-TB futhi. Kwakudingeka 

okunye ukwelashwa izinyanga eziyisithupha, kodwa 

manje ohlotsheni lwemithi yakhe kwabandakanywa 

izinyanga ezimbili zokujovwa nge-stretomycin zonke 

izinsuku. U-Xoliswa wachaza le mijovo njengezinto 

ezibuhlungu kakhulu ake zizwa. Zazishiya amagquma 

ezinqeni zakhe okwakufanele ukuthi azihlikihle. 

Imiphumela yokuhlolwa kukaXoliswa yabuya ikhombisa 

ukuthi wayengazweli ku-rifafour naku-streptomycin. 

Lokhu kwakusho ukuthi manje wayesene-MDR-TB. 

Welashwa nge-kanamycin, umjovo zonke izinsuku 

izinyanga eziyisithupha. 

“Ingxaki yaqala ngonyaka ka-2008, ngomhla ka-15 

Okthoba. Asobe ngalukhohlwa lolo suku!” kusho 

u-Xoliswa lapho ecabanga izehlakalo ezenzeka. 

“Ngangiyojova nge-kanamycin yami eyinjwayelo 

emtholmpilo i-Nolungile. Lapho ngifika, usista ophethe 

wangitshela ukuthi mangilinde ngaphandle kwamasango 

omtholampilo ngilinde i-ambulensi, ngaphandle 

kwananoma iyiphi incazelo ngalokho okwakwenzeka 

kimi nokuthi i-ambulensi yayingiyisaphi. Kwachazwa 

ngokuhamba kwesikhathi ... lapho ngifika e- Brooklyn 

Chest Hospital … ukuthi ngangine- XDR-TB. U-Dkt 

Swedu, owayesebenza ngalelo langa, wathi kimi, ‘Mama, 

sekukuwe-ke manje. Ukuthi ufuna ukuphila noma cha, 

kuncike kuwe konke.” 

“Ngesikhathi [ngangisesibhedlela] abangane bami 

bangishiya kwathi nesoka enganginalo ngaleso 

sikhathi nalo langijikela langishiya. Kwakungumama 

wami kuphela [namanye] amalungu omndeni eza 

ukuzongibona. Kwakunzima kakhulu emndenini wami 

ukwamukela isimo sami manje, ngoba kwakufanele 

ngibashiye. Udadewethu wathuthela eKapa ukuze abe 

seduze nami angisize. 

“Ngahlala e-Brooklyn Chest Hospital ngazitshela 

ukuthi ngangizophuza imithi yami ngilwe nalesi sifo 

ngisho ngabe kwakunzima,” kuqhubeka uXoliswa. 

“... Eminye yemiphumela emibi yemithi kwakuyisifo 

sohudo esinamandla ngokweqile esaholela ekuncipheni 

komzimba, nokucanuzela kwenhliziyo okungabekezeleki, 

ukubala okumbalwa.” 

“Ngaphuma esibhedlela ngaqhubeka nemithi yami 

emtholampilo iNolungile futhi, kodwa kulokhu 

kwakufanele ukuthi ngicophelele kakhulu [uku] gqoka 

imaski evala umlomo namakhala ukuze ngingadluliseli 

i-TB kwabanye abantu noma ngiyithole kwabanye abantu. 

Lapho ngingena ngaphakathi etekisini ngabona ukuthi 

akukho mafasitela ayevuliwe, ngangizocela abagibeli 

ukuthi bavule okungenani 

ifasitela elilodwa kanti uma 

bala ngangizovele ngifake 

imaski yami. Ngangikhumbula 

amagama ka-Dkt Swendu 

angenza ngaqina. Lapho 

ngibuyela emtholampilo 

ngisho amalungu eqembu lami 

[lo]kusizana ayengesaba. 

“Ngomhla ka-20 Okthoba 

2010 ngaxilongwa kwathiwa 

ekugcineni angisenayo 

i-TB futhi ngakhishwa 

emtholampilo iNolungile. 

Ngangiyinqobile i-TB 

ekugcineni, emva 

kweminyaka yomzabalazo 

emine. Yhu! Kwakungakholakali. Kwakunesikhathi 

U-Xoliswa waxilongwa 

i-TB ngonyaka 

ka-2006 lapho 

eqala ukuba 

ezimpawu zesifo 

ezifana nokuncipha 

emzimbeni, 

ukukhwehlela kanye 

nokujuluka ebusuku. 

lapho engangicabanga khona ukuthi ngangifa kodwa 

ngokubekezela kwaba nomvuzo.” 

I-TB NGALESO 


3

Qala lapha 

I-TB NGALESO 


UMLANDO OMFISHANE WE-TB 

“Ngaletha ungcweti kwezesifuba 

lapha. Uthi kufanele ngingene 

esanathoriyamu, mhlawumbe izinyanga 

ezi-4. Kunesizungu esibi, kodwa-ke 

mhlawumbe kungcono kakhulu 

uma bengakwazi ukungelapha.” 

u-George Orwell, umbhali wamanoveli 

kanye nombhali wezepolitiki. 

U-Orwell wabulawa yi-TB ngo-1950. 

Wayengomunye weziguli zokuqala 

ukuzama i- streptomycin ne-PAS. 

4 

I-TB ngesikhathi esedlule sobumnyama 

Ubufakazi obudala 

be-TB i-hominid 

eyayisigamu sesigidi 

seminyaka ubudala 

esatholakala 

njengenkwali yamatshe 

eNtshonalanga 

ne-Turkey. Inezingozi 

ogebhezini lekhanda 

elikhombisa isifo se-TB. 

1944 

1943 

U-Albert Schatz, 

isitshudeni seziqu 

ze-PhD saseMelika, 

sehlukanisa 

i-streptomycin. 

U-Swede Jörgen Lehmann uthola 

i-para-aminosalicylic acid (PAS), manje 

esetshenziswa ekwelashweni kwe-TB engazweli 

emithini eminingi (MDR-TB). 

1952 

Umphumela wokulwa 

ne-TB we-isoniazid 

utholwe ngabacwaningi 

kubandakanya usosayensi 

waseJalimani u-Gerhard 

Domagk. 

Ukwenzeka kwe-TB kwakudadlana 

okwaqinisekiswa ukuhlaziywa 

kwezakhi zofuzo kuvela 

ezinsaleleni zeminyaka yobudala 

engu-18,000 we-bison eseyaphela 

eNyakatho Melika. 

1959 

Iqembu labacwaningo 

lase-Italy lenza umuthi 

omusha obizwa 

ngokuthi i-rifampicin 

(RIF). 

Ngeminyaka 

yo-1890 

Izithombe zitholakale ku-Wikimedia Commons. Isithombe se- GeneXpert ngu-Elizabeth Mills. 

Odokotela ababili 

baseJalimani, u-Franz 

Ziehl no-Friedrich 

Neelsen, benza indlela 

yokuxilonga i-TB ngaphansi 

kwemayikhroskophu. 

Indlela yabo, ibizwa 

ngokuthi i-acid-fast stain, 

isasetshenziswa ukuxilonga 

i-TB. 

Izimo eziqinisekisiwe ezindala 

kakhulu ze-TB kubantu 

zatholakala ezinsaleleni zohlaka 

lwamathambo omama nosana 

lwakhe endaweni eyayicwilile 

ngaphambi komlando kwa- 

Israyeli. Ithimba lezesayensi 

lakhipha i-DNA yabhaktheriya 

emathanjeni eyaqondana 

nezinsalela ze-DNA yesifo sofuba 

i-Mycobacterium. 

Ngeminyak - 

Ngeminyaka 

yo-1960 

Ngemuva kokuqhubeka 

kweminyaka engama-20 

eyandulela, iminyaka yo-1960 

ingumaka omkhulu ekulweni 

ne-TB. Abantu banethembe 

lokuthi isifo singanqotshwa. 

“Uma ukubaluleka kwesifo 

kubantu kukalwa ngenamba 

yokufa esikubangile, 

isifo sofuba-ke kufanele 

sithathwe njengesibaluleke 

kakhulu kunazo zonke lezo 

ezesatshwayo, ubhubhane, 

ikholera nezinye ezifana 

nazo. Oyedwa kubantu 

abayisikhombisa kubona bonke 

abantu ubulawa yisifo sofuba.” 

- Robert Koch 

I-TB kwakuyisifo 

esijwayelekile eGibhithe 

yakudala. I-DNA 

ye-TB yatholakala 

ohlakeni lwamathambo 

oluyiminyaka yobudala 

engu-5,400 futhi 

nasezidunjini ezigciniwe 

eGibhithe ezibhekelwa 

ukusuka ngeminyaka 

yawo-2050 BC. 

“Ukuba nganginesifo sofuba... lo 

mqondo, obewethusa ngaphambilini, 

awusaqhqhazelisi muntu ... 

sekuvele ama-antibhayothiki, 

isanathotiyamu yanyamalala; 

ngokucabanga komphakathi … isifo 

sesinqotshiwe.” – Umsebenzi ovela 

ku-International Union Against 

Tuberculosis, 1962. Njengoba 

ecashuniwe ngonyaka ka-1964 

ngu-Salman Waksman, ingxenye 

yethimba eyathola i-streptomycin.

Isifo sofuba (TB) beyaziwa ngamagama amaningi iminyaka ngeminyaka: idliso, i-phthisis, 

i-scrofula, isifo sika-Pott, Inkosi yezifo kanye nesifo esimhlophe (noma ubhubhane olumhlophe). 

“Izimpawu zesifo zikanje: kunemfiva 

engabonakali, ngokujwayelekile iqala uma 

sekuya emphethelweni osuku futhi iba ngcono 

ngokufika kosuku olusha; lokhu kuphelekezelwa 

ukukhwehlela kakhulu ekuqaleni nasekupheleni 

kobusuku, nokukhishwa kwesikhwehlela...Izwi 

kungenzeka lihhadlazele noma linswininize 

liye phezulu, ukuphefumula kunzima, izihlathi 

ziphaphathekile bese kuthi umzimba wonke. 

Amehlo anokubukeka okukhathele, kanti isiguli 

sikhathele ... Kwezinye izimo kunomsindo 

oswebezayo noma ogohhozayo esifubeni...” 

U-Caelius Aurelianus, udokotela waseRoma, 

echaza i-TB ekhulwininyaka lesi-5 AD. 

1882 

U-Robert Koch, 

udokotela 

waseJalimani, 

umemezela ukuthi 

isifo sofuba 

i-Mycobacterium 

iyimbangela 

ye-TB. 

Iminyaka 

yo-1990 

Lapho i-HIV isabalalela 

emhlabeni osathuthuka, 

abantu abaningi baba 

ne-TB. Ukucabanga okuhle 

kweminyaka yo-1960 into 

yesikhathi esidlulile njengoba 

i-TB iba yimbangela yokuqala 

yokufa phakathi kwabantu 

abane-HIV eNingizimu Afrika. 

1868 

Udokotela 

waseFransi 

u-Jean-Antoine 

Villemin ufakazela 

ukuthi i-TB 

iyathathelwana. 

1991 – 

500 BC 

U-Hippocrates, 

othathwa njengomuntu 

owasungula imithi 

yasentshonalanga, 

uchaza i-TB njengesifo 

esijwayeleke kakhulu 

sesikhathi sakhe. 

1699 

IRiphabhliki yase-Lucca 

(ingxenye yase-Italy) iphasisa 

umthetho obeka ngempoqo 

izindlela zokulawula isifo se-TB 

eziqinile. Ukuhlolwa kwemizimba 

emva kokufa kuyadingeka, 

ukuvumela ukuthi umoya omusha 

udlule kuthathwa njengomsebenzi, kanti 

iziguli ziyakhuthazwa ukuthi zingakhiphi 

izikhwehlela ngaphande kwasengilazini noma 

kuveseli. IRiphabhliki futhi igcizelela ukugezwa 

kwezinto zokusebenza kanye nezinto zokulala 

okusetshenziswa abantu abane-TB. 

Ama-Middle 

ages 

1992 

2008 

Kwenzwa izihloko 

Abacwaningi babika 

okutholakele okuhle 

ezihamba phambili ngomuthi omusha 

Kuqubuka i-MDR- 

TB e-New York 

City. Ukubheduka 

kususa izinhlansi 

zentshisekelo 

ocwaningweni 

lwe-TB. 

njengoba iziguli 

ze-DR-TB zibaleka 

kumawodi 

okuhlukaniswa 

ngempoqo 

ezibhedlela ze-TB 

eNingizimu Afrika. 

obizwa ngokuthi 

i-TMC207 yokwelapha 

i-MDR-TB. Eminye 

imithi emisha ye-TB 

kanye nokwakhiwa 

osekwenziwe ngcono 

kwemithi emidala 

nakho kusendleleni. 

Ukuqubuka kwamadolobhakazi ehambisana 

nezimo ezimbi zokuhlala kuholela 

ekukhuleni kwezifo eziphathelene ne-TB 

nokufa. Kula makhuluminyaka alandelayo, 

ukubuswa ngamanye amazwe kanye 

nokuqalwa kwezimboni nakho kwaba 

nesandla ekusabalaleni 

kwe-TB. 

2009 

2011 

1546 

Udokotela wase-Italy 

u-Girolamo Fracastoro 

waphawula ukuthi i-TB 

iyathathelwana. Umbhalo 

wakhe uphakamisa 

ukuthi ukuqonda ukuthi 

i-TB ibangwa ama-ejenti 

athathelwanayo 

amancane aphila 

emzimbeni. 

Ukuhlola okusha kwe-TB 

okubizwa nge-GeneXpert 

kungenisiwe eNigizimu 

Afrika, kwehlisa kakhulu 

isikhathi sokuhlolela 

i-TB. 

I-TB NGALESO 


5

ISAYENSI YE-TB 

Bangaki abantu abane-TB? 

6 

Ukuvama 

Abantu 

baseNingizimu 

Afrika sebebonke 

49,004,031 

Abantu abane-HIV 

5,600,000 

Indiya IShayina 

Abaxilongwe 

ne-TB 

njengamanje 

490,000 

INingizimu Afrika inezehlakalo 

eziphezulu kunazo zonke ze-TB 

emhlabeni, emva kweNdiya 

neShayina. 

INingizimu 

Afrika 

MDR-TB 

9,070 

XDR-TB 

TB/HIV izifo ezihlangene 

TB 340,066 izimo ezintsha ze-TB 65,916 abelashwayo 

Isehlakalo Izinga Lokutheleleka 

Ukwelashwa 

kwe-TB 

Ukwelashwa 

Izindleko 

kwe-MDR-TBR181,600 

TB hospital 

R1,680 

594 

58% 

TB 

HIV+ 

Umuntu ongelashiwe one-TB ephilayo ingasisabalalisa 

isifo cishe ukufika kubantu abayi-15 ngonyaka. 

Ukwelashwa 

TB 

1 1 2 3 4 5 6 7 

MDR-TB 

1 2 3 4 5 6 7 

8 9 10 11 12 13 14 

15 16 17 18 19 20 21 

22 23 24 25 26 27 28 

29 30 31 32 33 34 35 

36 37 38 39 40 41 42 

43 44 45 46 47 48 49 

50 51 52 53 54 55 56 

57 58 59 60 61 62 63 

Imithombo: World Health Organization. 

2010 Global Tuberculosis Control Report. 

World Health Organization. 2010 

Tuberculosis Country Profiles: South Africa. 

Izinsuku njengesiguli 

esisesibhedlela 

Ukuvakasha njengesiguli 

esigulela ngaphandle 

64 65 66 67 68 69 70 

71 72 73 74 75 76 77 

78 79 80 81 82 83 84 

85 86 87 88 89 90 91 

92 93 94 95 

1 2 3 4 5 6 7 

8 9 10 11 12 13 14 

15 16 17 18 19 20 21 

22 23 24

ISAYENSI 

YE-TB 

Yini i-TB? 

Akufani ne-HIV, isifo sofuba (TB) asibangwa igciwane. 

Asibhozomeli amaseli bese siwasebenzisa ukuzizalanisa 

ngendlela lelo gciwane elenza ngayo. 

I-TB ibangwa wuhlobo lwebhaktheriya. Amabhaktheriya 

mancane kakhulu impela izinto eziphilayo ezineseli 

eyodwa. Sithola izinhlobo ezahlukene eziningi 

zamabhaktheriya emhlabathini, ekudleni, emizimbeni 

yethu, kanye nanoma yikuphi nje emhlabeni. Amningi 

amabhaktheriya asizungezile kanti emizimbeni yethu 

akukho monakalo awenzayo kanti amanye asilungele 

ngisho ukusilungela. 

Ibhaktheriya elithize ngqo elibhekene nomsebenzi 

omkhulu kakhulu ku-TB yabantu libizwa ngokuthi 

i-Mycobacterium. Igama elithi mycobacterum (elisho 

ukuthi “fungus-bacteria”) lanikezwa ngoba la maseli 

uma esekhulile elabhorethri futhi uwahlola ngaphansi 

kwemakhroskophu abhekeka njenge-fangasi. 

Isifo sofuba i-mycobacterium sibulawa ngokushesha 

ukubekeka engozini yelanga eliyihlaba ngqo. Uma 

kuvikelekile ekushiseni kwelanga, kuhlala kuphila futhi 

kuthathelana ukufika emasontweni ayishumi 

(isibonelo ematheni omile). Ibhaktheriya 

lingamela izihlanzi ezinamandla kakhulu futhi 

kaningi lihlala lisesimeni salo sokulala. Lidinga 

i-oksijini ukuze liphile – ngakho-ke libizwa 

ngokuthi ibhaktheriya elidinga umoya (aerobic 

bacterium). 

Isifo sofuba i-mycobacterium sikhula kancane, 

siziphinda ngokuzalana njalo emahoreni 

angama-24 ukuya kuma-48. Kuncane kakhulu 

lokhu kubhaktheriya. Amanye amabhaktheriya 

angazalana njalo emizuzwini engama-20. 

Linomzimba omise kwensimbi cishe ubude 

obungamamilimitha angu-0.2, obungeze 

babonwa ngamehlo enyama – kuphela 

ngaphansi kwemakhroskophu. Umzimba 

weseli uzungezwe udonga lwamaseli aqine 

ngokungajwayelekile nokuyindida. Lolu donga 

lwamaseli lwenza ukuthi kube nzima kabi 

ukwelapha nokuxilonga i-TB. 

Ilungu le-TAC uSizwe 

Nguqe ugqoka imaski lapho 

evolontiya emtholampilo 

Ubuntu eKhayelitsha. 

Isithombe ngu-Chelsea 

Maclachlan. 

I-TB kaningi isabalala uma omunye umuntu 

ekhwehlela. Vala umlomo wakho kanye nekhala 

lapho ukhwehlela futhi ubuso bakho ububhekise 

eceleni uma kukhona umuntu okhwehlelayo 

eduze kwakho. 


7


8 

1 

Uma uhogela ibhaktheriya le-TB, asheshe adlule ngomlomo 

nekhala bese eya emaphashini. Aya kulokhu esikubiza ngokuthi 

i-bronchioli yokugcina kanye ne-alveoli yamaphaphu akho. 

• Ama-terminal bronchhioli izingxenye ezincane kakhulu zebronchi, 

izakhiwo ezihola umoya osuka emigudwini yomoya 

phezulu (ikhala, umlomo noqhoqhoqho) uya kumathishu 

amaphaphu akho. 

• Ama-alveoli yizingxenye zethishu yamaphaphu futhi 

kunezindawo lapho i-oksijini evela emoyeni idonswa 

khona idluliselwa egazini lakho futhi isiwe kwezinye izitho 

zomzimba eziwudingayo. 

Isigaba 1: Abavikeli be- 

Macrophage bahlasela i-TB 

Isigaba sokuqala senzeka esontweni 

lokuqala uhogele ibhaktheriya le-TB. Uma 

ibhaktheriya lifika ku-alveoli yamaphaphu 

akho, ligwinywa amaseli akhethekile ohlelo 

lokuvimbela amagciwane olubizwa ngokuthi 

ama-macrophage. La ma-macrophage 

avamise ukutholakala kuthishu ye-elveoli, 

umsebenzi wawo ukugwinya nokuyekisa 

Uma kunamabhaktheriya amaningi kakhulu 

e-TB, noma uma i-microphanage angaqinile 

ngokwanele ukumelana nayo, i-TB ingazalana 

ngaphakathi ku-microphage. Lokhu kuholela 

ekucekelweni phansi kwemicrophage kanye 

nesifo sokunye, ama-macrophage aseduze 

agwinya amabhaktheriya. 

2 

Izigaba ezine zokutheleleka 

Isigaba 2: I-TB ifike yakhe 

ephashini lakho 

Uma ama-macrophage engakwazi ukulawula 

i-TB, isifo sakho singena esigabeni sesibili 

emva cishe kwesonto, lapho amabhaktheriya 

ephindaphindeka ngokushesha okukhulu. 

Lesi sigaba sihlala kuze kube yisonto 

lesithathu emva kokutheleleka kokuqala. 

4 

3 

Isigaba 3: Izivimbeli mzimba ziyalwa 

Emva cishe kwesonto lesithathu, 

umzimba wakho uletha amaseli ezivikeli 

mzimba amaningi kanye nesifo sofuba 

i-Mycobacteriyamu kuvamise ukuyeka 

ukuphindaphindeka ngokushesha. 

Kulesi sigaba ama-macrophage kanye 

ne-TB ngokujwayelekilee kufinyelela 

kubhalansi futhi isifo siba ngaphansi 

kolawulo. Okungenani kubantu 

abayisishiyagalolunye kwabayishumi isifo 

siyama lapha futhi ayibi i-TB ephilayo. 

Ngisho ngabe isifo sakho silawulekile, 

enye i-TB ingaphila iminyaka 

ngaphakathi kwama-macrophage. La 

Isigaba 4: Isizinda sezempi se-TB 

Cishe esimeni esisodwa ezimeni 

ezingama-20 , iphaphu aliphili 

ngokufanele futhi i-TB iphinde 

ivuseleleke emva kwezinyanga eziyi- 

12 ukuya kwezingama-24 kulandela 

ukutheleleka kokuqala. Isifo sofuba 

i-Mycobacterium esiphinde yavuka 

izalana ngokushesha futhi yakha umgodi 

kuthishu yephaphu, lapho izivikeli 

mzimba zomzimba wakho zingeke 

zikwazi ukufinyelela kubhaktheriya. 

I-Bronchiole 

I-Alveoli 

ma-macrophage athelelekile avalelekile 

ephashini lakho lonke ngodonga 

lwama-macrophage aphilile. Kulesi 

sigaba awathelelani, ngenxa yokuthi 

ama-macrophage angeke angene 

emigudwini yomoya wakho futhi angeke 

ukhwehlele ukhiphele ngaphandle 

noma uphefumulele ngaphandle. Uma 

izivimbeli mzimba zakho ziqinile 

, iphaphu liyaphila kusale kuphela 

imbobo kanye nesibazi kuthishu. 

Lesi sibazi ngokuhamba kwesikhathi 

singabonwa ku-X-reyi futhi siwuphawu 

lokuthi uke watheleleka ngesifo sofuba 

i-Mycobacterium. 

Ukusuka lapha, i-TB isheshe isabalale 

futhi ihlasele umzimba wakho bese uba 

nezimpawu kanye nezimpawu zesifo 

se-TB ephilayo njengokukhwehlela. 

Kulesi sigaba, uthelelana kakhulu 

ngoba isikhwehlela sakho (amafinyila 

owakhwehlelayo esuka emphinjeni 

wakho) anamabhaktheriya e-TB 

aphilayo. Ukuphinde aphile futhi 

kungenzeka uma izivikeli mzimba 

zakho zibuthaka, isibonelo zenziwa 

ukutheleleka nge-HIV noma indlala.

Umzimba wakho uzilwela kanjani 

• Uma ngabe izivikeli mzimba zomzimba wakho ziqinile, 

ziyakwazi ukugcina amabhaktheriya futhi ukutheleleka 

akusabalaleli phambili. Lokhu kubizwa nge-TB elele noma 

i-TB ebalulekile engenazimpawu (izigaba 1 ukuya ku-3). 

• Uma izivikeli mzimba zakho zibuthaka, angeke zikwazi 

ukugcina amabhaktheriya e-TB, asheshe asabalale. Uba 

nezimpawu bese ugula. Lokhu kubizwa ngokuthi i-TB 

ephilayo noma i-TB ebalulekile eqhubekayo (izigaba 1 

ukuya ku-3, kodwa ngaphandle kokulawulwa kokugcina 

ngaphezu kwesigaba sesi-3 se-TB). 

• Uma izivikeli mzimba zakho ziqinile ekuqaleni futhi 

zikwazi ukugcina amabhaktheriya e-TB, kodwa 

ngokulandelayo ababuthaka ungabe usakwazi ukuwalawula, 

amabhaktheriya aqala angene esimeni sokulala kodwa 

aphinde avuseleleke futhi bese eqala ukusabalala kanzima 

(isigaba 4). Lokhu kubizwa nge-TB yesibili noma i-TB 

ephinde yavuselelwa. Ingavuswa futhi ukutheleleka okusha 

namabhaktheriya e-TB, okuholela ekuvuseleleni futhi 

ukutheleleka kokuqala. 

Yelashwa kanjani i-HIV ne-TB 

ndawonye 

Ukuba ne-HIV ngokushesha kwandisa ingozi yokuba ne-TB 

ephilayo. ENingizimu Afrika balinganiselwa kuma-58% abantu 

abane-TB ephilayo futhi bane-HIV. I-TB futhi ingumbulali 

wabantu abane-HIV ohamba phambili. 

Ukwelapha i-TB kanye ne-HIV kanye kanye ngezinye izikhathi 

kungaba nzima kakhulu. Njengoba ama-ARV esiza izivikeli 

mzimba ukuthi zisinde, izivikeli mzimba ziqala ukulwa ne-TB. 

Lokhu kubizwa ngokuthi i-IRIS ((Immune Reconstitution 

Inflammatory Syndrome). Kungenzeka ukuthi iziguli zizizwe 

zigula kakhulu impela futhi kuyingozi. Ngenhlanhla, 

ucwaningo eminyakeni yakamuva lukucacisile ukuthi 

kukusiphi isigaba lapho kufanele kunikezwe khona 

imithi ethize. 

• Uma unesibalo se-CD4 esingaphansi 

kwama-350 futhi uxilongwe 

i-TB, kufanele ukuthi ufakwe 

ekwelashweni kwe-TB ngokushesha. 

Kufanele uqale ukwelashwa i-HIV 

ngokushesha lapho kuphela isigaba 

esibi kakhulu se-TB – izinyanga 

ezimbili zokuqala –ziphelile. 

• Uma isibalo sakho se-CD4 siphansi 

kakhulu – isibonelo, ngaphansi kwama-50 

– kufanele ufakwe kukho kokubili ukwelashwa 

kwe-HIV kanye nokwe-TB ngokushesha. 

! Izimpawu zesifo se-TB 

I-Pulmonary TB (i-TB 

yamaphaphu) 

• Ukukhwehlela amasonto amabili 

noma ngaphezulu 

• Ukukhwehlela uketshezi oluqinile 

noma igazi 

• Uhlevane, imfiva kanye nokujuluka 

ebusuku 

• Ukuncipha komzimba kanye 

nokungathandi ukudla 

• Ubuhlungu besifuba kanye 

nobunzima bokuphefumula 

Hlolelwa i-TB 

I-Extra-pulmonary 

TB (i-TB eyenzeka 

ngaphandle 

kwamaphaphu) 

• Ubuhlungu noma ukuvuvukala 

kwesisu 

• Ubuhlungu noma igazi uma 

uchama 

• Imfiva, ukucanuzela kwenhliziyo 

• Ukuqaqamba nezinhlungu 

emgogodleni noma emajoyintini 

• Izinkinga zokuzala 

Uma uba nezimpawu ezingenhla kufanele ucele ukuhlolelwa i-TB 

emtholampilo. Uma une-HIV, usengozini enkulu ephezulu kakhulu yokuba 

ne-TB futhi kufanele uzame ukuthi uhlolwe ngokuvamile kangangokuba 

kungenzeka. 

Indlela enkulu yokuhlolelwa i-TB ukuthatha isikhwehlela (amathe akhwehlelwe 

evela emphinjeni) futhi uyihlolele namagciwane e-TB. Ukuhlolwa kuzobuya 

lokho okuthathiwe kungenayo noma kubuye kunayo. 

Ukuhlolwa okuthi unayo kusho ukuthi kunokutheleleka nge-TB emaphashini 

akho futhi kufanele uqale ukwelashwa ngokushesha. 

I-TB 

ingelapheka! 

I-TB ivamise ukudinga ukwelashwa 

izinyanga eziyisithupha. Kubalulekile 

ukuhlala uphuza imithi yakho izinyanga 

eziyisithupha ezigcwele, ngisho ngabe usuzizwa 

ungcono. Uma ushesha uyeka kungenzeka ugule 

noma ube nokungezweli emthini. Ngisho ngabe 

imiphumela emibi yokwelashelwa i-TB ingaba 

mibi, imiphumela yokungayiphuzi imithi 

kungenzeka ibe mibi ngokwedlulele. (Bheka 

ikhasi 12 ukuze uthole ulwazi oluthe 

xaxa ngokwelashwa kwe-TB). 

Ukuhlolwa okuthi awunayo kusho ukuthi kungenzeka ukuthi 

awunayo i-TB. Kodwa-ke, abantu abaningi abane-HIV 

bahlolwa bangabi nayo, yize besenayo i-TB ephilayo. 

Uma une-HIV futhi unezimpawu zesifo se-TB 

kodwa ekuhlolweni kwe-TB ungenayo, 

kunokunye ukuhlola okungenziwa 

umtholampilo wakho ukubona ukuthi 

ingabe unayo ngempela yini i-TB ephilayo. 

I-X-reyi yesifuba ingasiza ukukuxilonga. 

Futhi, ungenza nalokhu abakubiza 

ukuhlolwa kohlobo lwamabhaktheriya 

e-TB, kodwa kuthatha amasonto ambalwa 

ukuletha umphumela. (Bheka ikhasi 20-21 

ngokunye ukuhlolwa kwe-TB). 

Le athikili iguqulwe ngu-Marcus Low encwadini eshicilelwe ngu- 

Alex Muller kuwebhusayithi TBOnline.info. 


9


10 

I-TB ENGEZWELI EMITHINI 

Ezimeni eziningi kakhulu, uma uphuza imithi ye-TB izinyanga eziyisithupha 

ezigcwele njengoba kushiwo, i-TB izokwelapheka. Kodwa-ke, uma uphuza 

imithi njengoba kudingeka, uma umtholampilo uphelelwa yimithi, noma uyeka 

ukuyiphuza ngenxa yemiphumela emibi, i-TB emzimbeni wakho kungenzeka 

ukuthi ingezweli emthini futhi imithi kungenzeka ingasasebenzi. Uma lokhu 

kwenzeka, kuzofuneka uqale usebenzise imithi emisha nebiza kakhulu 

enemiphumela emibi engaphathani kahle nhlobo. 

Kaningi kuyenzeka ukuthi abantu batheleleke 

nge-TB esivele ingasezweli emithini. Ukwethulwa 

kwezindlela ezingcono zokuyixilonga i-TB kuzosho 

ukuthi angeke unikezwe ukwelashwa osuvele 

ungazweli kukho. Noma ngabe kwenzekani, 

ithemba kuphela onalo ukusebenzisana kakhulu 

nodokotela wakho futhi uphuze imithi yakho 

ngendlela eshiwo. 

Yini i-MDR-ne-XDR-TB? 

• Uma ungazweli kuyo yomibili imithi emibili 

elwa ne-TB yomugqa wokuqala enamandla 

kakhulu, i-isoniazid (INH) ne-rifampicin (RIF), 

une-TB engazweli emithini eminingi (MDR-TB) 

• Uma ungazweli kunanoma yimiphi imithi 

ekilasini le- fluoroquinolone (isibonelo 

i-ciprofloxacin noma i-moxifloxacin), kanye 

okungenani owodwa kwemithathu yemithi 

yomugqa wesibili ejovwayo (capreomycin, 

kanamycin, ne- amikacin), kusho ukuthi-ke 

une-TB engezweli ngokuphelele emithini (DR). 

Zombili izimo ze-TB engazweli emthini kungenzeka 

zibulale. Okwamanje, iziguli ze-XDR-TB 

ikakhulukazi zisengozini ephezulu kakhulu yokufa. 

Sidinga ukuthi sibe lokhu sikhankasela ukwenziwa 

kwemithi emisha yokwelapha lezi zimo. (Bheka 

ikhasi 22-24 ukuze uthole ulwazi oluthe xaxa 

ngemithi ye-TB emisha). 

Inkinga enkulu 

I-TB engazweli emthini iyinkinga enkulu 

kakhulu kunokuba kufanele ngenxa 

yokuphathwa okubi kwezinhlelo zokunakekelwa 

kwezempilo. 

Ngonyaka ka-2008 kwakulinganiselwa 

ezehlakalweni ezintsha ezingu-440,000 

ze-MDR-TB emhlabeni wonke jikelele, uma 

kuqhathaniswa no-511,000 ngonyaka ka-2007, 

ngokwe-World Health Organization. I-MDR-TB 

iphendulela ngaphansi kwama-5% ezehlakalo 

ze-TB emhlabeni jikelele. Cishe ama-5% 

okutheleleka nge-MDR-TB aqhubekela ku- 

XDR-TB. Kodwa-ke, kubalulekile ukwazi ukuthi 

ngenxa yokungabikwa kahle okubi kakhulu 

kwezehlakalo ze-MDR ne-XDR-TB, izinamba 

ezingenhla ngezokulinganisela nje kuphela. 

Eqinisweni, ngaphansi kwama-10% azo zonke 

izifo zixolongwa ngempela. 

Uhlelo Lwamazwe Omhlaba Jikelele lokuQeda 

i-TB luhlambekisela ukuthi phakathi kuka-201 

no-2015, izehlakalo eziyizigidi ezingu-1.3 

ze-MDR ne-XDR –TB zizodinga ukwelashwa 

emazweni angama-27 anesehlakalo esiphezulu 

kakhulu sokungazweli kwe-TB emthini, 

kubandakanya iNingizimu Afrika. Lokhu 

kwelashwa kuzoba nenani lentengo eliyizigidi 

gidi ezingu- US$16.2. 

Le athikili iguqulwe 

ngu-Marcus Low 

encwadini eshicilelwe 

ngu-Alex Muller 

no-Kay Kim 

kuwebhusayithi 

TBOnline.info.

Isithombe ngu-Chelsea Maclachlan. 

I-TB Yamaphaphu (Pulmonary TB) 

I-Pulmonary TB i-TB yamaphaphu. 

Iwuhlobo lwe-TB olujwayeleke kakhulu 

njengoba ukutheleleka kwenzeka uma 

uhogela ibhaktheriya iya ephashini. 

(Funda ngezimpawu ze-TB yamaphaphu 

ekhasini 9). 

I-Extrapulmonary TB (Izinhlobo 

zonke ze-TB) 

I-Extrapulmonary TB itemu eliyisambulela 

sazo zonke izinhlobo zesifo se-TB 

ezingenzeka ngaphandle kwamaphaphu. 

I-TB ingathelela cishe nanoma yisiphi 

isitho somzimba wakho, kodwa ezinye 

izitho njengama-lymph node kanye 

nohlelo lwemizwa olukhulu (ubuchopho 

nomgogodla) kutheleleka kakhulu 

ngokujwayelekile. 

I-TB ye-Lymph node 

Lolu uhlobo oluvamise kakhulu lwe-TB 

engaphandle kwasemaphashini. I-TB 

kaningi ithelela ama-lymph node entanyeni 

nangaphezu kwama-clavicle (amathambo 

amancane ngezansi kwamahlombe akho), 

abe esevuvukala bese kuthi isikhumba 

esiwazungezile sivuvukale. Nanoma 

yiyiphi i-lymph node emzimbeni wakho 

I-Pleural TB (I-TB Yolwelwesi oluphatha 

amaphaphu) 

I-pleura isikhumba esincane esiwulwelwesi 

olukekelezele amaphaphu bese luwehlukanisa 

odongeni lomgodi wesifuba. Lunezingqimba 

ezimbili; olulodwa lunamathele emaphashini 

kanti olunye odongeni lwesifuba. Kunesikhala 

esincane phakathi kwalezi zingqimba lapho 

amabhaktheriya e-TB angaqoqelana khona 

azalane. Ngenxa yalokhu, indawo iyavuvukala 

futhi uma uthelelekile uzoba nemfiva futhi ube 

I-TB yethambo noma yejoyinti 

I-TB ingathelela futhi amathambo noma 

amajoyinti. Lokhu kubanga ubuhlungu 

nokuvuvukala kwendawo ethintekile. 

Kaningi kakhulu abantu abacabangi 

ukuthi izimpawu zabo zibangwa yi-TB, 

kodwa ngengozi, noma okunye ukulimala. 

Ukuxilonga i-TB yethambo noma yejoyinti, 

abaqeqeshelwe ezempilo kufanele bathathe 

I-TB ohlelweni lwemizwa olukhulu 

nemenenjayithisi ye-TB 

Uhlelo lwakho lwemizwa olukhulu lwakhiwa 

ubuchopho kanye nomgogodla. i-TB ingathelela 

kokubili, futhi kaningi kakhulu lokhu kwenza 

imenenjayithisi ye-TB – isifo solwelwesi oluncane 

olwemboze ubuchopho. Izimpawu zincike ekutheni 

ubuchopho bakho bushaya ngakuphi. ngokuvamile 

abantu abanemenenjayithisi ye-TB balala 

kakhulu. Abezweli ngokujwayelekile, abakwazi 

ukunyakazisa izandla zabo noma izinyawo noma 

bahambe, futhi angeke bakwazi ukukhuluma noma 

ukugxilisa amehlo abo. Imenenjayithisi ye-TB 

iyingozi futhi kunzima ukuyelapha. Ukuyixilonga, 

abaqeqeshelwe ezempilo kufanele benze i-lumbar 

puncture. Lokhu kubandakanya ukufaka inalithi 

emgogodleni ukuze kufinyelelwe oketshezini 

olusemgogodleni, oluxhumene nobuchopho 

bakho, ukuthola ukuthi ingabe akhona yini 

amabhaktheriya kulolo ketshezi. Uketshezi lubizwa 

ngokuthi uketshezi lomgogodla olubalulekile 

(central spinal fluid, noma i-CSF). 

ingatheleleka. Kaningi ama-lymph node 

avuvukele abanga ezinye izinkinga ngenxa 

yobukhulu bawo. Ukuxilonga i-TB yamalymph 

node, umsebenzi wezempilo uthatha 

isampula le-node ethelelekile. Lokhu 

kusho ukuthi kufanele ahlabe i-lymph 

node ngesirinji bese ethatha amaseli 

ambalwa ukuze awahlole ngaphansi 

kwemakhroskophu. 

nobuhlungu lapho uphefumula. Lokhu kuvuvukala 

kwenza ukuthi i-pleura ikhiphe uketshezi, oluma 

phakathi kwezingqimba ezimbili. Lolu ketshezi 

lubizwa ngokuthi i-pleuura effusion (umgudu 

odlula uketshezi olubangwa ukuvuvukala lungene 

emzimbeni). Ukuxilonga i-pleura TB, umsebenzi 

wezempilo kufanele athathe isampula le-pleural 

effusion fluid ayoluhlolela i-TB. Lokhu kwenziwa 

ngokufaka inalithi idlule odongeni lwesifuba iye 

esikhaleni esiphakathi kwezingqimba ze-pleura 

nokuthatha uketshezi oluncane. 

i-X-reyi, futhi kaningi basebenzisa izindlela 

eziyindida kakhulu zama-X-reyi ezifana 

nama-CT scan (computer tomographic 

scans) noma ama-MRI (magnetic resonance 

imaging). Njengezinye izinhlobo ze-TB 

engaphandle kweyamaphaphu, isampula 

elincane lamabhaktheriya e-TB kufanele 

akhishwe ethanjeni noma ejoyintini 

kusetshenziswa inalithi. 


11


12 

Yazi imithi yakho ye-TB 

Imithi ye-TB 

Imithi ye-TB Izakhiwo ezikhona Imiphumela emibi 

Rifampicin 

(R) 

Imithi ye-MDR-TB 

150 mg R0.58 R1.29 

450 mg R1.05 

600 mg R0.89 

R (60 mg)/ H (60 mg) [paed] R0.99 

R (300 mg)/ H (150 mg) R0.71 R1.01 

R (150 mg)/ H (75 mg) R0.41 

R (150 mg)/ E (275 mg)/ H (75 mg)/ Z (400 mg) R0.47 R0.73 

Isoniazid (H) 100mg R0.08 

300 mg R0.49 R0.66 

Ethambutol 

(E) 

Pyrazinamide 

(P) 

Streptomycin 

(S) 

100mg R0.37 

400mg R0.44 

Ukucanuzela kwenhliziyo, ukuhlanza, ubuhlungu besisu, nezimpawu 

ezifana nezeflu. I-Rifampicin kungenzeka yenze umbala Kokukhishwa 

umzimba (izinyembezi umjuluko, isidoda kanye nomchamo) owolintshi 

noma obomvu. I-Hepatitis ingumphumela omubi ongajwayelekile. 

Imfiva, ukuqubuka, i-peripheral neuropathy, i-neurotoxicity (ukulimala 

kwethishu yemizwa) kanye ne-hepatoxicity (ukulimala kwesibindi). 

Imiphumela emibi engajwayelekile ibandakanya ukugula ngengqondo, 

ijondisi kanye nokugoqana komzimba. 

Ukucanuzela kwenhliziyo, ikhanda elibuhlungu, isiyezi kanye 

nomonakalo ekuboneni. 

Ukucanuzela kwenhliziyo, ukuhlanza, ubuhlungu emajoyintini nejondisi. 

S (1 gm/3ml) R8.10 Ukulahlekelwa ukuzwa, ukulimala kwezinso, isiyezi, kuxhumanisa izinto 

okonakele, ukuqubuka, imfiva, izifo zeyisti kanye nenkwethu yomlomo. 

Iziguli ezingazweli ku-rifampicin ne-isoniazid zinesifo sofuba sokungazweli emithini eminingi (MDR). Imithi ye-MDR-TB inemiphumela emibi 

kakhulu impela. Ukuphuza imithi ye-TB engenhla njengoba kushiwo kuzonciphisa amathuba okudinga imithi ye-MDR-TB ekhonjiswe ngenhla. 

Umuthi we- 

MDR-TB 

Kanamycin 

(Km) 

Amikacin 

(Am) 

Capreomycin 

(Cm) 

Moxifloxacin 

(Mfx) 

Levofloxacin 

(Lfx) 

Ofloxacin 

(Ofx) 

Ethionamide 

(Eto) 

Prothionamide 

(Pto) 

Cycloserine 

(Cs) 

Terizidone 

(Trd) 

Paraaminosalicylic 

acid (PAS) 

Clofazimine 

(Cfz) 

Umthamo ngeyunithi 

ngayinye 

1 gm / 3 ml ibhodlela 

R17.00 

Imiphumela emibi 

Amanani entengo engxenye ezimele ngokubomvu. 

Ingxenye kahulumeni ngokulwandle. Uma inani 

lentengo lingabaliwe, alitholakali engxenyeni. 

Umuthi njengephilisi, , umjovo noma iphakethe 

Ukonakala kwezinso, ukulahlekelwa ukuzwa, isiyezi, yonke imizwa (ukonakala kuzo zonke izingxenye 

zemizwa), ubuhlungu endaweni okujovwe kuyo kanye nokuqubuka. 

100 mg R17.79 Ukonakala kwezinso, ukulahlekelwa ukuzwa, isiyezi, yonke imizwa, ubuhlungu endaweni okujovwe 

250 mg R34.43 

kuyo, ukuqubuka, i-hypokalaemia (iphotheziyamu ephansi egazini) kanye ne- hypomagnesaemia 

(imagneziyamu ephansi egazini). 

500 mg R50.57 

1000 mg R78.98 

1 g R82.91 R120.00 Ukonakala kwezinso, ukulahlekelwa ukuzwa, i- hypokalaemia (iphotheziyamu ephansi egazini), 

ukuqubuka, kanye nobuhlungu endaweni okujovwe kuyo. 

400 mg R3.87 R18.87 Ukucanuzela kwenhliziyo, isifo sohudo, ingxaki yokulala, isiyezi, izifo ezibangwa yiyisti kanye nokuzwela 

ekukhanyeni. Imiphumela emibi engavamile ebandakanya ukulimala/ukudabuka komsipha. 

250 mg R12.62 Ukucanuzela kwenhliziyo, isifo sohudo, ingxaki yokulala, isiyezi nokuzwela ekukhanyeni. Imiphumela 

500 mg R19.98 

emibi engavamile ebandakanya yonke imizwa kanye nokudabuka komsipha. 

200 mg R8.61 Ukucanuzela kwenhliziyo, ukuhlanza, ikhanda elibuhlungu, i-malaise (umuzwa ojwayelekile wokuzizwa 

400 mg R16.86 

ungaphilile kahle), i-insomia (ukungafikelwa ubuthongo), isiyezi kanye nokuzwela ekukhanyeni. 

Imiphumela emibi engavamile kubandakanya ukudabuka komsipha kanye nezinzwa zonke zomzimba. 

250 mg R1.45 R1.69 Ukucanuzela kwenhliziyo, ukuhlanza, isiyezi kanye nokukhathala kwengqondo. Imiphumela emibi 

engavamile ebandakanya ijondisi, ukudangala, i-peripheral neuritis (ukunsonsotha kwezandla nezinyawo) 

kanjalo nokuphazamiseka kokubona. 

Ukucanuzela kwenhliziyo, ukuhlanza, ukudangala, ukuhhema, ijondisi, ukuphazamiseka kokuya 

esikhathini kanye nokonokala kwezinzwa zonke. 

Ubuhlungu bekhanda obungapheli, isiyezi, amaphupho amabi, ihala, ukuhhema, ukudideka 

nokuphazamiseka kokulala. I-cycloserine kufanele isheshe imiswe uma isiguli sifuna ukuzibulala noma 

silahlekelwa ingqondo. Eminye imiphumela emibi ibandakanya ukuqubuka, ukonakala kwezinzwa zonke, 

ijondisi kanye nokuphazamiseka kokubona. 

250 mg R6.43 R13.59 Ukudangala, ixhala, ukuhlaselwa ukwesaba, isifo sengqondo, ukuhhema, i-paranoia (ukugula 

ngengqondo kodwa okuhlukile ekuhhemeni), isiyezi, ukukhuluma okungaqondile kanye nokugoqana 

komzimba. I-terizidone kufanele imiswe ngokushesha uma isiguli sifuna ukuzibulala noma sigula 

ngengqondo. Eminye imiphumela emibi ibandakanya ukucanuzela kwenhliziyo, ukuhlanza kanye namaaleji 

yesikhumba. 

Ukucanuzela kwenhliziyo, isifo sohudo, ukukhathala kwengqondo, i-hepatitis, i-hypothyroidism (uma 

i-thyroid gland ikhiqiza ihomoni ye-thyroid engenele) kanye ne-malabsorption syndrome (ukonakala 

emandleni amathumbu okumunca ukudla). I-PAS akufanele isetshenziswe ezigulini ezizwelayo ku-aspirin. 

Isikhumba esomile nesixebukayo, ukucanuzela kwenhliziyo, ubuhlungu besisu kanjalo nokuphelelwa 

umbala kwesikhumba, i-retina, i-cornea kanye nomchamo. I-Clofazimine nayo ingakubanga 

ukungaphatheki kahle kwamehlo, ukuzwela ekukhanyeni, ikhanda elibuhlungu, imfiva, ushukela owandile 

egazini kanye nokulimala kwesibindi. 

Linezolid 600 mg iphilisi R593.01 Ukucanuzela kwenhliziyo, isifo sohudo, isiyezi, ukungalali, ukonakala kwazo zonke izinzwa, 

ukuphazamiseka kokubona, amakaka anegazi kanye nezifo zeyisti. 

20 mg/ml isasipenshini 

(150 ml ibhodlela) 

R2,967.10 

Iziguli ezingazweli ku-isoniazid, rifampicin, fluoroquinolone kanye nemithi ejovwayo yomugqa wesibili zine-TB engazweli emithini kakhulu.

Umfanekiso ngu-Brice Reignier. 

Imiphumela emibi yemithi ye-TB mibi, kodwa ukufa nokuba nokungazweli emthini kubi kakhulu. 

Mandla, 

uyaphila?! 

Inyanga yesI-2 

Zisayekile ukuhlasela 

okwaManje. kodwa 

kungenZeka Zibuye. 

Inyanga yesI-5 

ngicabanga kanjalo. 

wena sipho? 

kodwa uMa seZiyekile? 

angeke ngiphile 

nalokhu kukhanya 

ingunaphakade. 

cha! 

Inyanga yesI- 4 

Zivikele iZinyanga 

eZiyisithupha 

eZilandelayo. 

Mandla. kungani 

ungasicishanga isihlangu 

sakho? kwenZekani uMa 

okwangaphandle kubuya? 

Mandla, 

uyaphila? 

lokho kukhanya kunginika 

ikhanda elibuhlungu, ndoda. 

ngaphandle, angiboni lutho 

olwaseZiZweni. 

ngicabanga 

ukuthi ngiyafa. 

uyaquMa! 


13


14 

Ukulawula isifo ekhaya 

1. Izimbobo zokungenisa umoya 

umtholampilo 

Umtholampilo: Imitholampilo yakhiwe ngezinhlelo 

zokungenisa umoya ezikhethekile ukuqinisekisa ukuthi umoya 

uhlala uzungeza. Imitholampilo futhi inezinto ezihleliwe 

njengophahla oluphezulu noma izimbobo ezindongeni 

ukuvumela umoya ukuthi ungene futhi uphume. 

Umtholampilo: Amabhentshi asemtholampilo 

abekwe ukuthi anikeze abantu isikhala esiningi 

abazolinda kuwo. 

ikhaya 

umtholampilo 

ikhaya 


Ikhaya: Ukuvula amafasitela abhekene noma 

iminyango emzini wakho kuzoba umphumela ofanayo. 

Ukwenza uhlaka oluphambene, kufanele ukwazi 

ukudweba umugqa oqondile phakathi kwamafasitela 

amabili avulekile. 

2. Ukugcwala kwabantu ngokweqile 


Ikhaya: Ungakwazi futhi ukuthi nisabalale ekhaya 

ngokusebenzisa ingadi noma isitubhu uma 

nivakashelwe abangane. Uma omunye umuntu 

egula, bayeke baphumule khona bezosinda endlini 

eseceleni. 


Isithombe ngu-Adam Malapa.

Wonke umuntu usengozini yokuthola i-TB, ngisho nasekhaya. Funda ukuthi uyinciphisa kanjani 

ingozi ngokulandela amasu imitholampilo ewasebenzisayo ukulawula ukusabalala kwesifo. 

3. Imaski 

umtholampilo 

Umtholampilo: Amamaski anikezela ngokuvimbela umzimba 

ukuthi udlulisele. Iziguli ze-TB kufanele njalo zigqoke 

amamaski. Emitholampilo, abasebenzi bezempilo nabo 

bagqoka amamaski. 

4. Ukukhwehlela nokuthimula 

umtholampilo 

Umtholampilo: Ingalo yethu ihlinzeka 

ngesivimbo futhi ifihla umlomo wethu 

kanye nekhala ukuze singasabalalisi i-TB. 

Ekhaya, khumbula lezi zimpawu! 

Isithombe ngu-Gawain Kripke. 

Isithombe ngu-Bruno De Cock/Médecins Sans Frontières. 

ikhaya 

ikhaya 

Ikhaya: Ekhaya, abanakekeli kanye namalungu 

omndeni bangawagqoka nabo amamaski. 

Ikhaya: Khumbuza umndeni ngalokhu uma besebenzisa izandla zabo 

ukuvala ukukhwehlela kanye nokuthimula. Uma unokukhwehlela 

noma ukuthimula ezandleni zakho, kugeze ngokushesha. 

Izithombe ngu-Chelsea Maclachlan. 

Isithombe ngu-Jose Cendon/Médecins Sans Frontières. 


15

UKULWA NE- TB 

16 

Ugadi uqapha umngcele we- Jose 

Pearson Tuberculosis Hospital. Iziguli 

kaningi zizama ukubaleka esibhedlela, 

ikakhulukazi ngezikhathi zamaholidi. 

Isithombe ngu-Mariella Furrer. 

Umbuzo Wokuvalela 

ngokwehlukanisa 

abantu abanesifo 

esithile 

ukuhlukaniswa ngempoqo kweziguli ezine-tB engazweli emthini kwenze 

izihloko eziphambili eminyakeni esandakudlula. u-Agnieszka wlodarski ovela 

kuSIGABA27 uhlola izixazululo ezinikezelwa yinqubomgomo entsha yeNingizimu 

Afrika yokunakekelwa okwenzelwa ezindaweni ezahlukene.

Umlando omfishane wokwelashwa 

ngokuhlukaniswa eNingizimu Afrika 

Unyaka ka-2008 nonyaka ka-2009 wabona izihloko ezihamba 

phambili ‘ngokubaleka’ kweziguli ezibhedlela ezisebenza 

ngokukhethekile nge-TB engazweli emthini (DR-TB) 

eGauteng, eMpumalanga Kapa kanye neNtshonalanga 

Kapa. Ngokweziqondiso zokwelapha zoMnyango Wezempilo 

ngesikhathi, iziguli kwakufanele ukuthi zahlukaniswe 

esigabeni sokuqala sokwelashelwa kwazo i-DR-TB. Lokhu 

kuvamise ukusho izinyanga eziyisithupha zokwehlukaniswa 

kodwa ngezinye izikhathi kuthatha isikhathi eside. 

Iziguli zazingajabule ngokuba kude nemindeni yazo kanye 

nemiphambo yazo yokuzeseka. Zazikhathazeka kaningi 

ngokuthi imindeni yazo izophila kanjani. Labo abasebenzayo 

bazizwa benexhala lokuthi bazolahlekelwa imisebenzi 

yabo um behamba isikhathi eside kakhulu. Ukwengeza 

ekukhathazekeni kwabo, izimo kulezi zibhedlela kaningi 

zazizimbi. 

Kwezinye izimo Umnyango Wezempilo wafaka izicelo 

zemiyalelo yenkantolo owawuzodinga ukuthi iziguli ‘ezeqile’ 

zibuyiselwe ezibhedlela ezikhethekile ukuthi ziyoqeda 

ukwelashwa kwazo. Kodwa-ke, ukuhlukaniswa ngempoqo 

kuyingxaki ngokokubona komthetho. Ngenxa yalokhu, 

kwatholakala isinqumo senkantolo eyodwa esatholakala 

ngokuphoqa iziguli ezine ezine-DR-TB ukuthi zaziqale 

ukwelashwa esibhedlela esikhethekile (icala lika-‘MEC 

Wezempilo, eNtshonalanga Kapa ephikisana no-Goliath kanye 

nabanye’). 

Ingabe ukuhlukaniswa ngempoqo 

kusemthethweni? 

Ecaleni lika-Goliath inkantolo yanquma yavuna 

ukuhlukaniswa okuyimpoqo, kodwa ukwahluleka kungenzeka 

ukuthi bekungahluka ukuba inkantolo yayicabange icala 

ngokweSigaba 36 soMthethosisekelo waseNingizimu Afrika. 

U-Ronelle wayelaliswe esibhedlela i- “Sunshine” Ward at Jose 

Pearson Tuberculosis Hospital ngaphezu kweminyaka emithathu. 


Isigaba 36 siqinisekisa ukuthi emphakathini ovulelekile 

nobusa ngokwentando yeningi amalungelo omuntu angeze 

aba nomkhawulo (ukuhlukaniswa ngempoqo okubeka 

umngcele elungelweni lenkululeko lokunyakaza) ngaphande 

kokubuza okusemthethweni okucabanga izinto ezahlukene. 

NgokweSigaaba 36 okulandelayo kuzokalwa: 

(a) isimo selungelo okufanele libekelwe umkhawulo (kuleli 

cala ilungelo lesiguli lenkululeko yokunyakaza njengoba 

kuqinisekiswe Isigaba 12 somthethosisekelo wethu); 

(b) ukubaluleka kokubeka umkhawulo emalungelweni omuntu 

(inkantolo ingaphikisana ngokuthi ukuvikelwa komphakathi 

kanye nempilo yomphakathi kusengozini); 

(c) isimo kanye nobungako bomkhawulo(okuwukuhlukaniswa); 

futhi 

(d) izindlela ezingabeki umngcele kakhulu ukufeza inhloso 

efanayo. 

Izinto eyesibili neyesine zifanele kakhulu. Singeze 

sathethelela ukwehlukanisa iziguli uma kungenamibhede 

eyanele ezibhedlela ezikhethekile ukuhlinzeka ukwelashwa 

kwawo wonke umuntu one-DR-TB. Abantu bekufanele 

baphindele emiphakathini yabo ngesikhathi besohlwini 

lokulinda lwasesibhedlela. Lokhu kusho ukuthi ngisho 

kuthiyori izinkantolo bezingalibekela umkhawulo ilungelo 

lesiguli lenkululeko yokunyakaza, umngcele ubungeke 

usize ngalutho njengoba abanye abaningi abane-DR-TB 

bethunyelwa emiphakathini yabo kanti inhloso yokuqinisekisa 

ezempilo angeke kuhlangantshezwane nayo. 

Ecaleni lika-Goliath, uma inkantolo yaayenze uphenyo 

ngeSigaba 36 okungenni bekungacabanga ngokunakekela 

okuncike emphakathini obekungaba ngcono 

kunokuhlukniswa. Lolu phenyo kungenzeka futhi lubhekele 

eminye imiphumela emibi yokuhlukaniswa, njengokuba kude 

nomndeni wakho isikhathi eside. 

Isikhathi sokunikezela kubantu abehlukene 

ukunakekela kwe-DR-TB 

Ukunqoba izinkinga zokwelashwa ngokwehlukanisa 

eNingizimu Afrika ukwenza inqubomgomo entsha 

yokunakekelwa okunikezelwe abanye abantu. Le 

nqubomgomo ifuna ukubhekana nezindaba eziningana 

lapho izishoshovu zikhankasele uguquko. Lezi zindaba 

zibandakanya ubunzima ezigulini ezilele esibhedlela 

izinyanga eziyisithupha, kanye nezinhlu zokulinda ezinde 

ngenxa yenamba enomkhawulo embhedeni wasezibhedlela. 

UKULWA NE- TB 

17

UKULWA NE- TB 

18 

Ukunakekela 

Kwezempilo 

Okubalulekile 

Cishe ezehlakalweni ezazisiwe ezingu-9,070 ze-TB 

engazweli emithini eminingi (MDR-TB) ngonyaka 

ka-2009, ezweni lonke iziguli ezingaphansi kwezi- 

5000 ezaqala ukwelashwa ngalowo nyaka ofanayo. 

Abaphathi beziguli ezine-MDR-TB abasendaweni 

ngezindawo (kodwa hhayi i-TB engazweli emthini 

ngokuphelele noma i-DR-TB) bazonciphisa 

inamba yezinsuku phakathi kokuxilongwa kanye 

nokuqala ukwelashwa. Umphumela wokugcina 

uzoba ukukhava kokwelashwa okungcono, 

ukudluliswa kwe-DR-TB okucishisiwe, kanye nokuthi 

kwenzeke ukuthi iziguli zithole ukwelashelwa 

eduze nasekhaya. Lokhu futhi kungenza ukuthi 

kube nokwanda kokwamukeleka emphkathini 

kokwelashwa kwe-MDR-TB. 

Ngokwenqubomgomo ewuhlaka ngabaphathi 

abasezindaweni ngezindawo be-MDR-TB, indlela 

entsha izosiza iziguli: 

• Ngokwamukela imisebenzi ebhekene nabo 

uqobo kanye nezidingo njengoba bezoba 

seduzane namakhaya abo; 

• Ukunciphisa ukudluliswa kwe-MDR-TB 

ngokusheshe kuqalwe ukwelashwa, 

okuzokwenza ukuthi kutholakale imibhede 

eminingana ekhona ekugcineni; 

Iyunithi 

ye-MDR-TB 

eyisathelayithi 

• Ukwenza ngcono ukubambelela ekwelashweni 

kusetshenziswa izinhlelo ezincike emphakathini; 

futhi; 

• Ukunciphisa izindleko ngokunciphisa ukuhlala 

okude ezibhedlela ezikhethekile. 

Inqubomgomo ewuhlaka ekwelashweni okwenzelwa 

ezindaweni ngezindawo iphakamisa uhlaka 

lwezempilo olulandelayo lokuphathwa kweziguli 

ze-DR-TB: 

Ukuphathwa kwe-DR-TB ezindaweni ngezindawo 

kusho ukudlulisela umsebenzi okubhekenwe nawo 

weziguli ze-MDR-TB ukwehlisa amazinga ohlelo 

lwezempilo kuphela uma behlangabezana nezindlela 

zokukhetha ezithize. Kubandakanya ukuphathwa 

kwe-DR-TB kumayunithi e-DR-TB asezindaweni 

ngezindawo, amayunithi ayisathelayithi e-MDR-TB, 

noma emphakathini kusetshenziswa amathimba 

angomahamba nendlwana, abanakekeli 

bomphakathi kanye nosizo lwasekhaya. Iziqondiso 

ze-MDR-TB ze-World Health Organization zichaza 

ukunakekelwa okuncike emphakathini kanye nosizo 

njengananoma yisiphi isinyathelo noma usizo 

oluhlinzekwe ngumphakathi, kubandakanya izimo 

lapho iziguli zithola khona ukwelashwa zihlala 

ngaphandle kwasesibhedlela. 

I-flow chart yohlelo olusha lokwelapha okuhanjiswe kwezinye izindawo 

Ithimba 

Elingumahamba 

nendlwane 

Iyunithi ye-DR- 

TB ehanjiswe 

kwezinye 

Ukunakekela 

Kwezempilo 

Okubalulekile 

Iyunithi 

ye-MDR-TB 


Ithimba 

Elingumahamba 

nendlwane 

Iyinithi ye-DR- 

TB enkulu 

Ukunakekela 

Kwezempilo 

Okubalulekile 

Iyunithi 

ye-MDR-TB 


Ithimba 

Elingumahamba 

nendlwane 

Decentralised 

DR-TB Unit 

Ukunakekela 

Kwezempilo 

Okubalulekile 

Iyunithi 

ye-MDR-TB 


Ithimba 

Elingumahamba 

nendlwane

Yini esingayenza ukusiza ukwelashwa kwe- 

DR-TB okuhanjiswe kwezinye izindawo? 

• Izinhlangano zomphakathi wabantu kufanele zisebenze 

ndawonye ukuqinisekisa ukuthi inqubomgomo entsha 

ibhekela konke ukukhathazeka kwabantu baseNingizimu 

Afrika okuvuswe ukwelashwa kwe-MDR-TB. 

• Abakhankasi badinga ukushiyelana ngolwazi ngokuthi 

iqaliswa kanjani ukusetshenziswa inqubomgomo 

emhlabeni wangempela. 

• Kufanele siqinisekise ukuthi ukuhanjiswa kwezinye 

izindawo izindleko zakho zenziwe kahle futhi 

zabhajethelwa. Lezi yizinto ezibalulekile ezinganquma 

impumelelo yenqubomgomo entsha nanoma iyiphi. 

• Kufanele sifune ukweseka ikakhulukazi ngamalungelo 

amaqembu abekeke engozini njengezingane, abahambela 

kwamanye amazwe, abakhoseli kanye nabasebenzi 

basemgodini . 

• Inani elifanayo lokuzinikela kanye nokunakekela 

eliqhube impendulo ku-HIV kufanele futhi lisetshenziswe 

ukubhekela ubhubhane lwe-TB eNingizimu Afrika. 

• Sidinga ukweseka impendulo ye-TB ne-DR-TB ezungeza 

emalungelweni abantu. 

Imitholampilo esezindaweni ezahlukene ivumela iziguli ukuthi zifune 

ukwelashwa eduze nasemakhaya. Isithombe ngu-Chelsea Maclachlan. 

Izibhedlela ezigcwele 

ngokweqile angeke zihlinzeke 

ngokunakekela okwanele 

ezigulini ezibuthakathaka. 


Imithombo: AIDS Law Project Report, ‘Protecting Public Health’, (2009); Case 13741/07; 

Communicable Diseases and Notifiable Conditions Regulations. 

UKULWA NE- TB 

19

UKULWA NE- TB 

20 

UKUHLOLWA KWE-TB 

OKUNGCONO 

Kokubili ukugcoba okuyisitayela sakudala 

kanye nomshini i-GeneXpert omusha 

sha kuyasetshenziswa e-Site B Clinic 

eKhayelitsha ukuxilonga i-TB. U-Elizabeth 

Mills wahamba wayophenya. 

Isikhathi 

esidingekayo 

Ukuzwela 

Ukuxilongwa 

kokungazweli 

komuthi 

Unyaka 

owenzwe 

ngawo 

Imakhroskophu 

yokugcoba 

ngokuthathiwe 

1 2 

Amahora ama-2 ( Kudinga 

umsebenzi omningi 

owenziwa ngochwepheshe 

baselabhorethri. 

Eqinisweni, kungathatha 

amasonto ukuthola 

imiphumela.) 

68% 

Cha 

1886 (Wenziwe 

ngu-Franz Ziehl no- 

Friedrich Neelsen) 

Ukuhlola kwe- 

Xpert MTB/RIF 

Amahora ama-2 

(Kungenziwa ukuhlolwa 

okuningi kanye kanye 

kungabi ngomzamo 

omncane wochwepheshe 

elebhu.) 

98% 

Ukuxilongwa 

kokungazweli ku- 

rifampicin 

2004 (Wenziwe inkampani 

ebizwa ngokuthi yi- 

Cepheid, Inc.) 

I-Xpert MTB/RIF ukuhlolwa okuzwelayo. Kubantu 

abayi-100 njalo abane-TB ephilayo izoxilonga 

ngokulungile abangama-98 kulezi zehlakalo. 

Ngokuphikisana, i-smear macroscopy kukhomba 

i-TB ezehlakalweni ezingama-68 kweziyi-100. Lokhu 

kusho ukuthi i-smear macroscopy izokweqa izehlakalo 

ezingama-32 ekubeni ukuhlola kwe-GeneXpert 

kuzokweqa ezimbili kuphela. 

Ngaphezu kweminyaka eyikhulu i-TB beyixolongwa 

kusetshenziswa indlela ebizwa ngokuthi i-smear microscopy. 

Manje, sesinokuhlola kokubili okusheshayo nokuthembeke 

kakhudlwana. Lokhu kuhlola kubizwa ngokuhlola i-GeneXpert 

MTB-RIF – noma i- GeneXpert ukufingqa. 

Ingabe busebenza kanjani 

ubuchwepheshe be-GeneXpert? 

Isitayela sakudala se-smear microscopy sidinga ochwepheshe 

abanamakhono ukuthi bachithe amahora benza imisebenzi 

ehlukene yaselabhorethri. Iplatifomu ye-GeneXpert okuningi 

kwalezi zinyathelo kuyazenzela futhi kwenza ukuthi kukwazeke 

ukuqeda ukuhlola okuningi kusetshenziswa ochwepheshe 

baselabhorethri abambalwa. Yingakho nje manje iziguli 

sezikwazi ukuthi imiphumela yokuhlolwa emahoreni nje 

kunamasonto. 

Uchwepheshe welabhorethri ulungisa isampula lesikhwehlela 

eliqoqwe emtholampilo, alibeke kukhathriji, abeke ikhathriji 

emshinini we-GeneXpert, umshini bese wenza konke. 

Njenge-smear microscopy, kunezigaba ezintathu 

ekuhlolweni: 

1. Ukulungiswa kwesampula: Ochwepheshe baxova 

isampula lesikhwehlela ngamakhemikhali akhethekile 

kakhulu ahlukahlukene. La makhemikhali asiza 

ukuhlukanisa indawo ethize ngqo ye-TB DNA, 

kodwa angeke sikwazi ukubona i-TB ngaphansi kwemakhroskophi. 

2. Ukukhulisa: Uma i-TB DNA ethize ngqo 

seyihlukanisiwe, ochwepheshe badinga eningi yayl ukuze 

kube lula ukuhlola. Lolu hlelo lokuhlukanisa indawo 

efunekayo ye-DNA kanye nokukopisha umfanekiso 

kuphela leyo ndawo kubizwa ngokuthi ukukhulisa. 

3. Ukuthola: Uma ngabe sekunama-DNA amaningi 

akopishiwe ochwepheshe bangazama ukuwathola. 

Imolekhuli esetshenzisiwe kulokhu kuthola siyibiza 

nge-probe. I-probe yenziwe kusetshenziswa ikhodi 

yezakhi zofuzo eyenza ukuthi kunamathele ku-DNA 

ochwepheshe baselabhorethri abayiseshayo (kulesi 

simo i-TB). I-probe kuvamise ukuthi yenziwe ukuze 

kuthi uma inamathela ku-DNA ishintshe umbala noma 

ikhanye kakhulu. Uma uchwepheshe eyibheka esebenzisa 

imakhroskophu bese ebona ukuthi umbala ushintshile 

noma elinye isampula selikhanya kakhulu, uyazi ukuthi 

i-probe kukhona i-TB eseyiyitholile. Lokhu kusho ukuthi 

isampula lesikhwehlela linayo. I-GeneXpert konke lokhu 

kuyazenzekela.

Yenza ukuthi ukuhlolwa kube lula! 

I-GeneXpert ibalulekile ikkhulukazi ekuxilongeni i-TB kubantu 

abane-HIV. Lokhu kungenxa yokuthi i-smear microscopy 

kunezinga eliphezulu lokungabi nayo okungesilo iqiniso (uma 

ukuhlolwa kuthi awunayo i-TB ephilayo, kodwa empeleni 

unayo). I-GeneXpert izoqinisekisa ukuthi izehlakalo ezimbalwa 

ze-TB ezihamba zingaxilongwanga futhi zingelashiwe. 

INingizimu Afrika manje seyithenge imishini engama-30. 

Ngonyaka ka-2011 enkulumeni yebhajethi, uNgqongqohe 

Wezempilo u-Aaron Motsoaledi uzibophezelele ukuhlinzeka 

i-GeneXpert kumalabhorethri e- National Health Laboratory 

Systems (NHLS) ekupheleni kuka-2012. 

Kodwa-ke, izindleko ziyinkinga enkulu. Umshini i-GeneXpert 

ubiza u-US$17,000 (ZAR R117,800) kanti ikhathriji ngayinye 

esetshenziswa ngokuhlola ngakunye ibiza u-$16.86 (R118.02). 

I-Cepheid kufanele yehlise izindleko zemishini kanye 

namakhathriji ngokushesha. 

I-NLHS kufanele futhi iphenye ukuthi ingazehlisa kanjani 

izindleko eziphezulu ezihambisana nayo, njengokuhanjiswa, 

ukuphrinta nentela, okulinganiselwa ku-R83.29 ngokuhlola 

ngakunye. 

INingizimu Afrika kufanele yelule izinzuzo zohlelo lwe- 

GeneXpert ezinganeni. Kunzima ukuqoqa amasampula 

esikhwehlela ezinganeni ukuze sihlolwe kusetshenziswa 

iplatifomu ye-GeneXpert. Imitholampilo idinga ukucabanga 

ngokushesha izindlela ezilula zokuqoqa amasampula 

ezinganeni. I-MSF isebenzise ngempumelelo umshini 

wenkungu, nawo owaziwa ngokuthi inebhulayiza, ebekwa 

ebusweni bengane. Lokhu kufanele kwenziwe ukuthi 

kutholakale kuyo yonke imitholampilo lapho amasampula 

ezikhwehlela eqoqwa khona ezinganeni. 

Isithombe ngu-Elizabeth Mills. 

UKULWA NE- TB 

21

UKULWA NE- TB 

22 


Ngu-Claire 

Wingfield, 

Treatment 

Action Group

Imithi 

yesikhathi esizayo 

Emva kwamashumi eminyaka enqubekela phambili encane, imithi emisha 

ye-TB isisendleleni ekugcineni. Kodwa-ke, ezinye izinselele zizodinga ukuthi 

ngaphambi kokuba le mithi ifinyelele emtholampilo wangakini. 

Amakhulunyaka esifo sofuba silokhu singelapheki. 

Kwase kuthi, phakathi kweminyaka yo-1940 no-1970 

ukutholakala kwama-antibhayothiki amasha kanye 

nokwelashwa ngenhlanganisela kwashintsha 

yonke into. Sasinemithi, ngakho-ke kwakuyindaba 

yesikhathi nje ukuthi siyihambise futhi siyisebenzise 

ngendlela elungile. Ngeshwa lokhu kulula ukukusho 

kunokukwenza. 

Ngemuva kuka-1963, lapho kwakutholakala ikilasi Elisha 

lemithi ye-TB, ukwenziwa kwemithi emisha kwabe 

sekuma ukwenziwa kwemithi emisha. Kwakungesikho 

nje ngeminyaka yo-1990, lapho ukuvela kokungazweli 

emithini kwe-TB (DR-TB) kwashayisana nobhubhane 

lwe-HIV e-United States naseYurophu, abacwaningi 

kanye nezinkampani ezenza imithi zavuselela uthando 

lwazo lokwenza imithi engcono ye-TB . 

Kusukela ngalesi sikhathi ucwaningo lokwelashwa 

kwe-TB seluvuseleleke kabusha. Manje sesinemithi 

emisha esendleleni ezayo eshumini leminyaka. 

Izinhlanganisela eziyisithpha ezivela emakilasini 

emithi evele ikhona nemisha iyahlolwa ezinhlolweni 

zokwelapha, okwamanje nezifundo zangaphambi 

kokwelashwa . Imithi esivele ikhona ebisetshenziswa 

ngaphandle kwelebuli (ngamanye amazwi, izinhloso 

ezingagunyazelwe) ukwelapha i-TB sezihloselwe 

futhi ukuze zifinyeze ubude bokwelapha, ukunciphisa 

imiphumela elimazayo, nokwenza ngcono imiphumela 

yokwelapha. 

Izinhlanganisela eziqhubeke kakhulu zokwelapha 

yi-TMC207 (i-bedaquiline esandokuqanjwa kabusha) 

evela kwa-Tibotec kanye ne-OPC-67683 (i-delamanid 

eqanjwe kabusha) evela kwa-Otsuka Pharmaceuticals. 

Zombili izinhlanganisela zisesigabeni esesihambe 

kakhulu zezinhlolo zokwelapha. Onyakeni, izinkampani 

kulindeleke ukuthi zifune imvume yokusebenzisa le mithi 

ekwelapheni i-DR-TB. 

Injabulo ngalezi zinhlanganisela iqedwa ukukhathazeka 

ngokuthola imvume yokulawula emhlabeni jikelele 

kungenzeka kube inselele. Kuncike ekutheni amazwe 

aziguqula kanjani izidingo zawo zokulawula, amandla 

okuxilonga, kanye nezinhlelo zokwelapha i-DR-TB, le 

mithi ingathatha iminyaka ukuthi ibe khona jikelele 

emazweni lapho i-TB iwububhane khona. 

TMC207 

I-TNV207 seyiqhubeke kakhulu nokwenziwa, ngakhoke 

onke mehlo aseku-Tibotec. Inkampani seyiqalile 

uhlelo lokusebenzisa ukuzwelana nokwandisa 

uhlolo lokufinyelela ekufinyeleleni kwangaphambi 

kokugunyazwa ezigulini ezinokhetho lokwelashwa 

olunomkhawulo noma ezingenamuthi wokwelashwa. 

Lezi zinhlolo zezinhlelo bezisetshenziselwa 

izidambisigciwane kanye nemithi yomdlavuza. Kodwake, 

akukho muthi we-TB oke wenziwa ukuthi utholakale 

ngale ndlela. I-TMC207 ngakho-ke isewudaba lokuhlolwa 

ukuqinisekisa ukufinyelela okunokwenzeka kusheshe 

emuthini owethembisayo ngesikhathi kuqinisekiswa 

futhi ukuthi usetshenziswa ngendlela 

efanele. 

Ukukhathazeka ukuthi uma 

izinhlanganisela zisetshenziswa 

ngendlela engafanele – nemithi 

ehambisanayo embalwa esebenza 

ngempumelelo – kuzoba nezinhlobo 

ezintsha zokumelana nemithi ze-TB 

ezingavela ngokushesha. Lokhu 

kungabeka umkhawulo emtheleleni 

wesikhathi eside wananoma 

yimuphi umuthi obhubhaneni. 

Kudingeka sizivume lezi zinselele 

ndawonye nesidingo esiphuthumayo 

sokuqinisekisa ukufinyelela emithini 

Siyayidinga i-TMC207 

Nakuba i-TMC207 isahlolwa, 

ulwazi njengamanje 

olutholakalayo lube 

nomthelela ezigulini eziningi 

ezine-TB engazweli emthini 

wokuthi ziyafuna ukuwuphuza 

lo muthi ukwenza ngcono 

ithuba lazo lokuphila 

nokunciphisa isikhathi 

sokwelashwa. Izishoshovu 

zicele i-Tibotec ukuthi lo muthi 

iwenze ukuthi utholakale, 

kodwa selokhu kungakenzeki. 

UKULWA NE- TB 

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UKULWA NE- TB 

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ye-TB enezinguquko kubantu abafayo. Kunezingxoxo 

eziningi kangangokuthi kungahlinzekwa kangcono 

kakhulu lokhu kufinyelela – ngaphambi nangemuva 

kwemvume – nokuthi singaqiniseka kanjani ukuthi 

iziguli ziyazuza ezinhlelweni zeqophelo eliphezulu 

ezingenayo imingcele engenasidingo. Khona lapho, 

kufanele kuthathwe izinyathelo ukubeka umkhawulo 

kanye nokuqapha ukuvela kokungazweli emthini. 

Kunomsebenzi okubhekenwe nawo wokusebenzisa 

ngendlela efanele umuthi omusha okungesiwona nje 

Nangale kwenqubekela 

phambili esandukwenzeka 

ocwaningweni lomuthi we-TB 

kufanele sihlale siqaphele 

ekwethembeni kwethu. Yize 

imithi manje esenziwa kuyiyona 

ethembisayo emashumini 

eminyaka, ayikakeneli ukuqeda 

i-TB njengesabisa izimpilo 

Isithombe yi-Jose Cendon/Médecins Sans Frontières. 

zomphakathi. Asinalwazi 

oluqoqiwe lokuthi le mithi singayisebenzisa kahle kangakanani 

ezinganeni nolwazi olunomkhawulo ngokuthi ingahlangana kanjani 

nokwelashwa ngezidmbisigciwane. Ngenxa yalokhu, labo bantu 

kunokwenzeka ukuthi baguliswe isifo esibi kakhulu kungadingeka 

ukuthi balindele imithi emisha. Ukwethembisa ukuthi imithi emisha 

isendleleni nokuthi kufanele silungiselele ukuyinikezela ngempumelelo 

noma nini uma idingeka. 

Umuthi Ukusetshenziswa Isigaba Isimo 

Ukwenza izinloso ezintsha zemithi evele ikhona 

rifapentine + isoniazid LTBI ukufinyezwa kokwelashwa Isigaba II Uphelile 

isoniazid LTBI Isigaba III Ukuhlaziywa kolwazi 

rifapentine DS-TB ukufinyezwa kokwelashwa Isigaba II Ukubhalisa 

rifapentine + moxifloxacin DS-TB ukufinyezwa kokwelashwa Isigaba II Ukubhalisa 

moxifloxacin DS-TB ukufinyezwa kokwelashwa Isigaba III Ukubhalisa 

gatifloxacin 

Imithi emisha 

DS-TB ukufinyezwa kokwelashwa Isigaba III Ukuhlaziya ulwazi 

AZD5847 TBA Isigaba II Awukabhaliswa 

PNU-100480 DR-TB Isigaba II Awukabhaliswa 

SQ 109 DS-TB/ DR-TB Isigaba II Ukubhalisa 

PA-824* DS-TB Isigaba II Ukubhalisa 

OPC-67683*(delamanid) DR-TB Isigaba IIb Ukuhlaziya ulwazi & Nokulandelela iziguli 

TMC207*(bedaquiline) DS-TB Isigaba II Ukubhalisa 

DR-TB Isigaba IIb Ukuhlaziya ulwazi & Nokulandelela iziguli 

LTBI = Ukutheleleka nge-TB Elele; DS-TB = I-TB Ezwela Emuthini; DR-TB = I-TB Engazweli Emuthini 

* Kukhonjiswa ekilasini lomuthi omusha 

owabenzi kuphela. Izinhlelo ze-TB kuzwelonke kanye 

nabakhankasi bokwelashwa babamba iqhaza elikhulu 

ekwethulweni ngempumelelo kwananoma yimuphi 

umuthi omusha noma uhlobo olusha. Izinhlelo ze-TB 

kufanele ziqinisekise ukunikezela okuthembekile 

kwemithi yeqophelo eliqinisekisiwe kanye nokufinyelela 

ngesikhathi ekuhlolweni kokungazweli emthini. 

Ukusheshe kuxilongwe i-TB kubalulekile ukuze 

kufakwe iziguli ekwelashweni okulungile, kuncishiswe 

ukuthelelana, kanye nokwenza ngcono imiphumela 

yokwelapha. Abakhankasi kufanele bafune ukungenelela 

okwethembisayo kwezinhlelo zikazwelonke, 

kubandakanya ukwenziwa kwezinqubomgomo 

zokuqondisa ukuqala kwazo ukusetshenziswa. 

Imithi emisha yezingane 

Izingane zenza cishe ama-20 omthwalo we-TB 

emhlabeni jikelele. Lokhu mhlawumbe kuwunikeza 

izibalo ezincane ngenxa yobunzima bokuqinisekisa 

ukuxilogwa kwe-TB ezinganeni. Futhi zisengozini 

ekhulile ngokuqhubeka kwesifo ngokushesha. Kodwa 

kuze kube manje ayikho kulezi zinhlanganisela ebisike 

yahlolwa ezinganeni. Izingane kufanele zisheshe zifakwe 

ohlelweni lokwenziwa kwemithi ukuze nazo zizosizakala 

emithini emisha. Kunesidingo esisha futhi socwaningo 

oluthe xaxa ekuphepheni nasekusebenzeni kahle 

ngokusebenzisa imithi ekhona njengamanje ye-NDR-TB 

ukwelapha izingane ezinokungazweli emithini ye-TB. 

Imithi evele ikhona kanye nemithi emisha ye-TB ezinhlolweni zokwelashwa kusukela ngoJuni 2011

Isithombe yi- Travel Aficionado. 

Qeda 

I-South African Clothing and Textile Worker’s Union 

(SACTWU) yenze Uhlelo Lwempilo Yomsebenzi olukhombisa 

ukuthi abaqashi nezinyunyana bangahlanganyela kanjani 

ukwenza izimo zokusebenza ezinempilo. Okubalulekile, 

lolu hlelo lusebenzisa indlela yokunakekela kwezempilo 

okubalulekile okuhambisa phambili ukuvimbeka nokuthatha 

i-TB njengento embi. 

Luyini Uhlelo Lwezempilo Yomsebenzi 

Lwe-SACTWU? 

I-SACTAWU inyunyana yezohwebo enkulu kanazo zoke 

embonini yezimpahla zokugqoka nezindwangu eNingizimu 

Afrika. Uhlelo lwayo Lwezempilo Yomsebenzi (Worker 

Health Programme (SWHP)) lwaqala ngonyaka ka-1998 

njengephrojekthi yemfundo ye-HIV/AIDS. 

Namhlanje i-SWHP ihlinzeka ngokunakekela okuphelele 

– yonke into kusukela ekuhlungeni ukuya ekuhloleni 

i-TB emsebenzini 

Ngu-Elizabeth Vale 

Indawo yokusebenza enempilo yinhle kuwo 

wonke umuntu. Abasebenzi abafinyelela 

ekunakekelweni kwezempilo okuseqophelweni 

eliphezulu nokwesekwa bahlala bephilile, 

baphila kangcono futhi bayakwazi ukuhlinzekela 

imindeni yabo. Izinhlelo zezempilo emsebenzini 

nazo zifanele abaqashi ngoba abasebenzi 

abaphilile basebenza ngokukhuthala kakhulu. 

ukuya ekwelapheni nasekwesekeni. Uhlelo lusebenzisa 

abaqeqeshi, amakhansela angaqeqeshiwe, onesi kanye 

nabanakekeli abasemakhaya. Ukusebenzisa amathimba 

angomahambanendlwana, kuhlinzeka abasebenzi bamafektri 

ngokufinyelela ekunakekelweni kwezempilo okubalulekile, 

akunandaba ukuthi bakuphi. 

UKULWA NE- TB 

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UKULWA NE- TB 

26 

Umxhumanisi 

wezokuqeqesha u- 

Gregory Hoedemaker 

ukhuluma 

nabasebenzi 

njengengxenye 

yohlelo lokuqwashisa. 

Isithombe ngomusa 

we-South African 

Clothing and Textile 

Workers’ Union. 

Onyakeni owedlule, i-SWHP yandile yanikezela uhlelo lwe-TB 

oluphelele, kubandakanya imfundo yasemsebenzini kanye 

namaseshini okuqeqesha. “Besihlola uhlelo lokwelapha i-TB 

emadolobhenikazi aseNtshonalanga Kapa”, kusho u-Nikki 

Soboil, Umqondisi we-SWHP. “Iyabasebenzela ... abasebenzi, 

futhi nabaqashi bajabule kakhulu.” 

Lusebenza kanjani Uhlelo Lwe- 

SACTAWU Lwezempilo Emsebenzini? 

1. Ukuqeqesha 

Abaqeqeshi be-SWHP bavakashela izindawo zokusebenza 

zonke izinsuku ukuyokwenza amaseshini ezemfundo 

e-TB ne-HIV efemini. Lezi zingxoxo zivamise ukwenzeka 

kuphuzwa itiye noma ngelantshi enkantini. Njengoba isikhathi 

sinomkhawulo, abaqeqeshi bethula imiyalezo esebenzisekayo 

“yokuya ekhaya” egxile ekuvimbeleni, ekwaziseni abasebenzi 

ngokulawula ukutheleleka okuyisisekelo kanye nezimpawu 

zesifo se-TB. Abaqeqeshi bashiya amaphosta kanye nezinye 

izinto zokukhuthaza ukulawula isifo, ukuhlunga kanye 

nokuhlolwa. 

Ukwengeza kulezi zingxoxo, i-SWHP ihlosele futhi amagosa 

okuqeqesha okujulile. Amagosa aya emihlanganweni 

yokufundisana emibili ukuya kwemithathu emahhovisi 

enyunyana, akhava i-HIV, TB kanye namalungelo endaweni 

yokusebenza. 

2. Ukulawula isifo 

Ngesikhathi samaseshini ezemfundo efektri, abaqeqeshi 

be-SWHP bakhuthaza izindlela eziyisisekelo zokulawula 

ukusabalala kwe-TB, njengokuvula amafasitela, ukukhwehlelela 

kuthishu kanye nokugeza izandla. I-SWHP futhi 

ikhuluma nabaphathi befektri ngokulawula isifo. Lokhu 

kungabandakanya ukuphakamisa amalambu e-UV, amathishu 

noma ukungena nokuphuma komoya okungcono. I-SWHP 

ikwazile ukunikezela amafektri ngokokukhipha ijeli engenaalkhoholi 

yokugeza izandla. Abaqeqeshi bakhuthaza amalungu 

e-SACTAWU, asebenza embonini yezimpahla zokugqoka 

nezindwangu, ukuthi basebenzise iziqephu zendwangu 

ukwenza amasayiduku. 

3. Ukuhlungelwa nokuhlolelwa i-TB 

Abaqeqeshi ngokwenjwayelo bahlungela iqembu i-TB, bebuza 

abasebenzi ukuthi kukhona yini izimpawu zesifo abanazo. 

Amathimba onesi kanye namakhansela angaqeqeshiwe 

balandelela lokhu kuvakasha zonke izinsuku ukuhlola 

nokuhlungela i-TB. 

Ukuhlowa kwe-TB kubandakanya izitsha zokuqoqa 

isikhwehlela endaweni yokusebenza noma uma abasebenzi 

bevakashela umtholampilo we-SWHP ukuyohlola. Uma 

imitholampilo ye-SWHP ikude, abasebenzi badluliselwa 

emtholampilo woMnyango Wezempilo ukuyohlola. Kulezi 

zimo, unesi ovela ku-SWHP uyafona ukuhlola ukuthi 

umsebenzi useyilandile yini imiphumela yakhe yokuhlolwa. 

Uma imiphumela yesikhwehlela ingenayo i-TB kodwa 

umsebenzi enezimpawu zesifo zokwelashwa ze-TB, i-SWHP 

yenza ukuhlolwa kwamabhaktheriya bese bemdlulisela kuma- 

X-reyi umsebenzi uma kudingeka. 

4. Ukwelashwa kwe-TB 

Umtholampilo we-SWHP e-Salt River yiyona kuphela indawo 

yokwelapha i-TB okungesiyona ekahulumeni, nengazimele 

eNtshonalanga Kapa. Abasebenzi bangakhetha ukuthi 

bazokwelashwa yi-SWHP noma emtholampilo wasendaweni 

woMnyango Wezempilo. Amalungu e-SACTAWU amaningi 

kakhulu ahlolwe atholakala ene-TB elashwa kusetshenziswa 

umtholampilo we-SWHP ngaphandle uma behamba noma 

besebenziea kude. Kuze kube namhlanje, i-SWHP inezinga 

lokuphilisa elingama-100%. 

U-Soboil uthi impumelelo yohlelo lokwelapha lusizwa 

ukubambisana okuhle kanye nethimba elizinikele. 

“Ukubambisana kubalulekile ngempela ... . Umnyango 

Wezempilo ... usixhumanisa nemitholampilo ethize ngenxa 

yalokho siyakwazi ukudluliseka kalula. Siyakwazi ukuthola 

imithi kalula futhi amakhithi ethu okuhlola siwathola kubo. 

Kufanele kube nokubambisana okuthize kungenjalo angeke 

kusebenze.”

5. Usizo 

Emasontweni amabili okuqala okwelashwa i-TB, abasebenzi 

bathatha ilivu yokugula. Ngalesi sikhathi, kuyenzeka 

bavakashele umtholampilo zonke izinsuku noma unesi 

we-SWHP uya kubo. Onesi be-SACTAWU basebenzisa uhlelo 

lokwelapha ngokuqapha ngqo (directly observed therapy 

(DOT)) ukuqapha ukubambelela kweziguli, kodwa banquma 

ukuthi bazosiqapha ngokuvama kangakanani isiguli kuncike 

ekutheni wenza kahle kangakanani lowo muntu ekwelashweni. 

Abasebenzi bangakhetha futhi ukuthola i-DOT efemini 

yabo, lapho-ke basekelwa ngosuphavayiza babo noma onesi 

emsebenzini. I-SWHP ixhumana nabaphathi kanye nonesi 

emsebenzini ngokwelashwa kwabasebenzi, ilivu yokugula 

kanye nezinye izinto okufanele zenziwe, ukuze kwenzeke 

ukwelashwa ngokwemithetho yomsebenzi. 

Ubudlelwano benyunyana nomqashi 

I-SWHP izohlolela wonke umuntu i-TB efektri nangale 

kokuthi uyilungu le-SACTAWU yini noma cha. Nakuba 

amalungu e-SACTAWU kuphela kanye nemindeni yawo 

eza emitholampilo ye-SACTAWU, abanye badluliselwa 

emitholampilo yoMnyango Wezempilo ukuyonakekelwa 

khona. 

Uhlelo lwe-TB lwe-SACTAWU ludinga ukwesekwa umqashi 

ukuze lufeze inhlolo yalo: yokuthuthukisa impilo yabasebenzi. 

Uma impilo yabasebenzi iqondwa ukuthi isiza bubilini, 

izinyunyana kanye nabaqashi bayakwazi ukusebenza ndawonye 

bephokophele kule nhloso. 

Yini esingayifunda oHlelweni 

Lwempilo Yabasebenzi Lwe-SACTAWU? 

Sidinga imitholampilo ebhekela abasebenzi 

Imitholampilo eminingi kakhulu eNingizimu Afrika ivula 

phakathi kuka-07:30 no-15:00. lokhu kusho ukuthi abantu 

abasebenzayo kaningi abakwazi ukuwasebenzisa. Ngokuhlukile, 

imitholampilo ye-SACTAWU ivula kusukela ngo-06:30 ukuya 

ku-18:30, kubandakanya Imigqibelo. Engxenyeni enkulu, 

imitholampilo ye-SACTAWU isebenza ngokubeka izikhathi 

ukuze amalungu ezokwazi ukubhuka izikhathi ezifanele bona 

kangcono. Bamukelekile futhi ukuza ngokuthi bazizele nje. 

Imitholampilo eminingi eNingizimu Afrika idinga ukubhekela 

abasebenzi ngokuvula ngezikhathi ezingaphandle kwamahora 

ayinjwayelo okusebenza. 

Ukubambisana kwenza umehluko 

I-SWHP ikwazile ukubambisana noMnyango Wezempilo kanye 

nabaxhasi bamazwe omhlaba jikelele ukwenza uhlelo lube 

yimpumelelo. Imiphambo yokuxhumana kanye nobudlelwano 

bugcina uhlelo lusebenza, luqinisekisa ukudluliselwa 

okusebenza kahle kanye nokufinyelela kuzidingongqangi. 

USista Vuyiswa ukholwa ukuthi ukuphila kahle kwabasebenzi into ehamba phambili 

ohlwini olukhulu lohlelo.Isithombe ngu-Elizabeth Vale. 

kwenZenjani kuMbali? 

uyigqoka kanjani iMaski 

eMphakathini? 

angithandi ukugqoka le Maski. 

akungiphathi kahle. kodwa kufanele 

ngiyigqoke ukuZe ngiZokwaZi 

ukuvikela abanye abantu ekusabalalei 

kwe-tb. ngifisa sengathi abantu 

bangayeka ukungibuka. 

Izinhlelo zomsebenzi azikhuthazi nje kuphela iziguli ukuthi zifune ukwelashwa kodwa futhi ziphoqelela 

nomuzwa omkhulu wokuqonda ngaphakathi emphakathini ngokubanzi. Umfanekiso nguSizwe Nguqe. 

Sidinga abantu abazinikele, abaqeqeshiwe ukubhekana 

nezindaba zezempilo emsebenzini 

Amathimba e-SWHP azinikele emsebenzini wawo futhi anikezwe 

amandla ngolwazi oludingekayo. Bahambisana nezintuthuko 

zesayensi, ukuxilonga kanye nezindlela zokulawula isifo, kanye 

nabo bonke abasebenzi abangafundile bathole ukuqeqeshwa 

ngokuthola izitifiketi. 

Sidinga ukufinyelela ngale kwabasebenzi ngabanye 

Uhlelo Lwezempilo Yabasebenzi lwe-SACTAWU lwelulela ngale 

kwbasebenzi ngabanye ukuya emindenini yabo nasemiphakathini. 

USista Vuyiswa, omunye wonesi emtholampilo we-SACTAWU 

eSalt River, uthi ingxenye enhle kakhulu yomsebenzi wakhe 

ukuthi ngokwazi isiguli esisodwa se-TB, uthola ukwazi umndeni 

waso futhi. “Ukwakha ubudlelwano nemindeni kukhuthaza 

imindeni ... ukweseka isiguli ekwelashweni nokungivumela ukuthi 

ngihlole ngokuhlungela i-TB amanye amalungu omndeni.” 

I-SWHP seyiqalile futhi ukufinyelela ezikoleni, lapho ihlinzeka 

khona ngemfundo ye-TB eyisisekelo. 

UKULWA NE- TB 

27

IZINDABA BRANCH ZAMAGATSHA 

NEWS 

28 

Izindabazegatsha 

Ngu-Luckyboy 

Mkhondwane 

Fundisa intsha 

nge-HIV 

Akwanele okwenziwa ezikoleni zethu ukufundisa intsha 

esencane nge-HIV, ubulili, ukukhulelwa kwentsha 

kanye nokuvinjelwa kwezifo ezithathelwana ngocansi 

(ama-STI). Lolu udaba olubaluleke kakhulu njengoba 

intsha esencane, njengawo wonke umuntu, isengozini 

yokutheleleka uma iya ocansini. 

Amalungu eGatsha le-Treatment Action Campaign 

(TAC) eKatlehong South bebekhathazekile ngezehlakalo 

eziphezulu zokukhulelwa kwentsha esencane 

endaweni yawo. Babekhathazekile futhi ngemibiko 

evela emtholampilo wasendaweni okhombisa ukuthi 

inamba enkulu yezingane zasezikoleni eziphakeme ziza 

emtholampilo zizofuna ukwelashelwa igonoriya, i-STI 

ejwayelekile. Banquma ukuthi kufanele benze okuthize 

bese bephakamisa lolu daba nabalingani be-TAC. 

UNthabiseng Maretlane Umkhankasi Wezempilo 

Emphakathini we-TAC ovela eKatlehong South. 

Esebenzisana noDikeledi Senong, ongumsebenzi 

Wokufundisa Ngokuvimbela Nokwelashwa we-TAC 

uMaretlane sebebhekene nenkinga. Bobabili baqale 

ukunikezela amaseshini ezemfundo akhava ukukhulelwa 

kwentsha esencane, ama-STI, HIV kanye noshintsho 

I-TAC ikhumbula u-Xolani Khumalo 

Ilungu lesikhathi eside le-TAC uXolani Khumalo ushone ngomhla 

ka-13 Juni 2011. UXolani, Umsebenzi Wokufundisa Ngokuvimbela 

Nokwelashwa eMgungundlovu, wajoyina i-TAC ngonyaka ka-2004. 

Ngonyaka ka-2009 waba nguMkhankaseli Wezempilo Emphakathini 

we-TAC, akabe nguye kwaze kwafika isikhathi sokudlula emhlabeni. 

UXolani wayenamandla kakhulu futhi 

esebenza kanzima. Uzokhunjulwa 

kakhulu ngumndeni wakhe, abalingani 

bakhe emsebenzini, amalungu egatsha 

nomphakathi. Sengathi umphefumulo 

wakhe ungalala ngokuthula. 

Isithombe ngu-Luckyboy Mkhondwane. 

lwendlela yokuziphatha eKatlehong High School kanye 

neThuto Pele High School. Bobabili izitshudeni kanye 

nothisha ezikoleni ezimbili balwemukele uhlelo. 

Amaseshini ezemfundo anikeza izitshudeni iplatifomu 

yokukhuluma ngokukhululeka ngobulili bocansi kanye 

nezinselele ababhekana nazo njengentsha esencane. 

Kaningi bacabanga ukuthi abakwazi ukuxoxa ngalezi 

zindaba nabazali babo nothisha. Njenoba uMaretlane 

noSening bobabili kungabesifazane abasebancane, 

kulula ukuthi intsha ikhulume nabo. 

“Izitshudeni ziyakhuluma kakhulu futhi ziyajabula uma 

zikhuluma ngezindaba zobulili nezobulili bocansi, kanti 

nezinga labo lokuhlanganyela liyathokozisa kakhulu,” 

kusho uMaretlane. “ Kodwa badinga imfundo enkulu 

kakhulu ezindabeni ezifana ne-HIV, ama-STI kanye 

nobulili bocansi.” 

Intsha esencane ayikwazi ukuhlukanisa phakathi 

kwe-HIV ne-AIDS, kusho uMaretlane, ngisho bazi 

ukuthi i-HIV idluliswa kanjani. “Ukukhathazeka kwabo 

okukhulu” eqaphele, “ukukhulelwa.” 

“Ngingathanda ukulubona lolu hlelo luphuma luya kuzo 

zonke izikole eziphakeme endaweni,” kusho uMaretlane. 

“Ikakhulukazi ne-HTC-(HIV Counselling and Testing) 

ephakanyisiwe emkhankasweni wezikole, njengoba 

izitshudeni zizozilungeselela kangcono ukuhlolelwa 

i-HIV nangokusebenzisa uhlelo banganikezwa amandla 

okwamukela isimo sabo uma behlolwe baba phozithivu.” 

I-TAC ikhumbula uSithembiso Mkhize 

Ilungu lesikhathi eside le-TAC uSithembiso Mkhize ushone ngomhla 

ka-17 Juni 22011. USithembiso wajoyina i-TAC ngonyaka ka-2002. 

Ubengumsebenzi Wokufundisa Ngokuvimbela Nokwelashwa 

we-TAC eThekwini. USithembiso ubebandakanyeka emkhankasweni 

oyimpumelelo owenziwa yi-TAC wokuqinisekisa 

ukwelashwa ngama-ARV kweziboshwa eJele 

lase-Westville. Ngesikhathi edlula emhlabeni 

uSithembiso ubeqashwe yiNyuvesi yaKwaZulu- 

Natali eMgungundlovu. Sengathi umphefumulo 

wakhe ungalala ngokuthula.

A = Appetite Loss C = Chest Pains T = Tiredness 

N = Night Sweats & Fever O = Ongoing Cough W = Weight Loss 

IF YOU HAVE ONE OF THESE SYMPTOMS OF TB, 

ACT NOW 

BY GOING TO YOUR NEAREST CLINIC 

FOR A FREE TB TEST! 

TB/HIV CARE ASSOCIATION 

www.tbhivcare.org • Tel 021 425 0050

IsiZulu - Treatment Action Campaign

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