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A Remarkable Story of Recovery: Building Leaders and Advocates For TB/HIV

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Thirteen-year-old Tinuke (not real name) had been ill for a while with a persistent cough, fever and progressive weight loss. When she sought medical evaluation at the Massey Street Children’s Hospital, one of several hospitals in Lagos supported by the US. Agency for International Development (USAID) funded Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) project, a presumptive diagnosis of tuberculosis (TB) was made by the clinical staff and she was asked to do some investigations. These investigations included a sputum GeneXpert assay as well as a blood test for Human Immunodeficiency Virus (HIV). The HIV test returned positive which meant that Tinuke was infected with HIV. During post-test counseling, she revealed that she had known her HIV status for a while now and had even been on treatment with antiretroviral (ARV) drugs, but had stopped treatment several months before her current illness.

TInuke’s father, Mr. Alade (not real name), who had accompanied her to the hospital, revealed that his wife had tested positive to HIV and died last year after an illness, despite being on treatment with antiretroviral drugs. He therefore considered the ARVs ineffective, and for this reason, had stopped bringing his daughter to the clinic for her routine drugs.

When Tinuke’s GeneXpert result came out, it was confirmed that she had TB. Tinuke commenced TB treatment at a directly observed treatment short course (DOTS) clinic which they were referred to, and two weeks later, restarted her antiretroviral therapy (ART). The facility staff, trained and supported by the SIDHAS project, had several counseling sessions with Mr. Alade and educated him on the relationship between TB disease and the HIV infection and the need for complete adherence to treatment.

Mr. Alade promised to ensure that his daughter adhered to both treatments, by accompanying Tinuke to every scheduled clinic appointment. Within a month of commencing the anti-TB drugs, Tinuke’s health improved significantly and she was able to engage in her normal activities and return to school. Her remarkable recovery astonished Mr. Alade, who had a change of perception about the effectiveness of anti-TB and antiretroviral drugs. He even mentioned that, with the benefit of hindsight, his daughter’s history of ill health was similar to the symptoms that plagued his late wife, and it was probably an untreated TB illness that led to her demise.

Today Mr. Alade is a very happy man. Tinuke doesn’t miss her clinic appointments and her health has continued to improve. Mr. Alade has volunteered himself as a treatment mentor, encouraging other parents during clinic sessions, to always visit the clinic and adhere to medications. He is a vocal and active leader and advocate for TB-HIV treatment in his community; contributing towards progress to end TB in Nigeria

The SIDHAS project continues to support numerous facilities in Nigeria to integrate TB and HIV into health service delivery and ensure that people living with HIV, who are more susceptible to TB infection, have access to TB screening, prevention and treatment services.

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