Doctor turns TB shock into a positive

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Copy of st main TBgcis7611.JPG GCIS File photo: In 2012, South Africa diagnosed about 6 200 XDR-TB cases.

Johannesburg - It took one cough and a sputter to change the life of a West Rand doctor who went from being the doctor to the patient after she contracted extensively drug-resistant tuberculosis (XDR-TB) at Leratong Hospital in Ekurhuleni.

Now, her choice to be part of a clinical access programme aimed at introducing a new XDR-TB treatment in the country could help pave the way for thousands of XDR-TB patients to get better faster.

“I woke up one morning and I was getting ready to go to work like every other normal person,” remembers Dr Thato Mosidi. “I went to brush my teeth and I coughed into the basin. I coughed up some blood.”

TB is usually characterised by symptoms such as night sweats, weight loss and a persistent cough – if the TB has attacked the lungs.

Mosidi had been feeling tired, but she said that was normal for a public sector doctor who works long hours and nights.

According to Mosidi, she had only the one cough, but the sight of blood in the basin was enough to send her straight to the doctor.

“It was literally only one cough,” she said. “One cough and I was ready to rush and get tested and get treatment.”

TB is usually treated with a six-month course of drugs. However, drug-resistant strains often require more drugs for longer and take up to two years to treat.

Mosidi’s doctor ran a series of tests on samples of her sputum to diagnose what kind of TB she had. While this kind of testing is available in the public sector, Mosidi benefited from what was likely a faster turnaround in results by going through her medical aid.

She remembers the exact moment she got the call with her results. She had XDR-TB, which is resistant not only to common anti-TB drugs, but also at least half the second-line medicines used to treat multidrug-resistant TB.

“The doctor said ‘I have some bad news for you’,” she says. “I literally started crying right then and there, and I was in the middle of a mall.”

In 2012, South Africa diagnosed about 6 200 XDR-TB cases, but with limited space in the facilities that can treat it, only about 11 percent of these cases were ever treated, said Dr Norbert Ndjeka, who heads the Department of Health’s division on HIV, TB and drug-resistant TB.

What started as shock for Mosidi quickly evolved into terror – then concern for her 3-year-old daughter.

With weaker immune systems, children, the elderly and people living with HIV are very susceptible to contracting TB if they live with someone who has it.

“I think it’s any mother’s nightmare to even imagine that you could give your little child something so serious. I was more scared about that than I was about myself being sick.”

 

Mosidi is now seven months into XDR-TB treatment. For the majority of her treatment, she has also been receiving a drug called bedaquiline.

Approved for use in the US and Europe, bedaquiline is the first new drug developed to treat TB in 40 years. Although not yet approved for use in South Africa, a government clinical access programme is allowing patients to take the drug under close monitoring.

 

If safety data obtained during the programme meets Medicine Control Council standards, Ndjeka said the government would push for fast-track approval of bedaquiline. – Health-e News Service

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