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Touched by TB

Christina Scott

Toto Ngqu works as a car guard in the Cape Town dorp of Fish Hoek every Sunday to raise funds for his BA studies at the University of the Western Cape.

The 21-year-old from Mount Frere in the Eastern Cape is also something of a get-tested-and-take-your-muti activist, as the result of his volunteer work in the play Touched by TB.

The play was commissioned as a thank you message from University of Stellenbosch medical researchers to more than 1000 residents of the Cape Flats who are participating in a complex seven-country study of how tuberculosis spreads through homes. Researchers checked the story, written and directed by science theatre specialist David Muller, to ensure that it was free of the many urban legends surrounding the microbe.

As a result of those performances, Toto has been in regular contact with his family in Khayelitsha ever since his four-year-old niece Linathi contracted TB. He wants to ensure to that the preschooler takes her daily medication for the entire six months. ''I know now what happens when you don't take the drugs regularly,'' he said.

''I come from Elsies River and you could see on the faces of the audience that they were responding to the storyline,'' said Touched by TB actress Pauline Aaron, who plays the role of a mother who trusts her footballer son when he claims that he is taking his TB pills and doesn't monitor him closely. Her son stops taking the drugs when he feels better, develops multi-drug-resistant strain and dies.

After the community performances, Stellenbosch University immunology professor and chest doctor Gerhard Walzl was peppered with questions from the audience. The actors also performed for the medical school faculty, to help assess the effectiveness of their message.

Dr Gill Black is the Scottish-born Stellenbosch University immunologist who commissioned the play. She is a South African co-investigator with colleagues Kim Stanley, Nulda Beyers, Nelita du Plessis and Nokwanda Ngombane in the global Biomarkers for TB project.

The African researchers - including South Africa, Malawi, the Gambia, Uganda and Ethiopia - are part of a worldwide effort to find out why some people are able to resist the bacillus.

The extraordinarily detailed South African wing of the study, which began as a pilot project in 2005, includes about 200 people who have TB, some of whom are ill. Not only does the study track their treatment and the progress of their disease, it also tracks the health of more than 1100 of their households over several years. Special attention is also paid to TB patients who have HIV - or may be infected during the course of the study.

The researchers are tackling the illness with a battery of new and sophisticated immunity tests, including monitoring how blood from people with TB will respond to a range of proteins.

Another high-tech test falls under the futuristic-sounding title of transcriptomics, a field of chemistry which didn't exist a few years ago. ''Transcriptomics allows us to study each patient's entire set of ribonucleic acids or RNA, which is a single strand of critically important genetic information,'' Dr Black explained.

The researchers also study participants' serum samples using metabolomics, which tests the unique chemical ''fingerprint'' or history within byproducts known as metabolites.

''Very few of the people who are infected with TB will develop an active form of the disease. We are hunting for markers which will show who will get sick and who will not. In the long run, we want to have a test that can say, yes, you've been exposed to TB and we can say whether you're at risk,'' the immunolgist said.

Despite the length and complexity of the study, Black is in no doubt of its worth. ''It's going to answer some really important questions.''

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* Touched by TB had its first public performance on World Tuberculosis Day on Wednesday March 24 at SciFest Africa in Grahamstown in the Eastern Cape and toured surrounding townships. Professor Valerie Corfield from the Centre for Molecular and Cellular Biology, a joint effort by the Medical Research Council and the University of Stellenbosch, hosted a free exhibit called The Trouble With TB at SciFest as well.

* This story originally appeared in the Mail & Guardian newspaper online at www.mg.co.za

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