Saving Lives and improving livelihoods through community multi – drug Resistant tuberculosis care
Tasiu was diagnosed with multi drug resistant TB (MDR TB) in January 2014 and is one of many such patients spread across Kano State. Tasiu’s battle with tuberculosis (TB) began in 2008 while he was training to become a teacher at the Federal College of Education in Kano State. He noticed what at that time appeared to be a mild cough. He visited the nearest patent medicine vendor (PMV), where an over the counter drug was given to him. He took the cough medications as prescribed but his cough never went away. His condition continued to deteriorate. He started noticing drenching night sweats and the fever became more frequent triggering a danger alert that now he needed to see a doctor and get a proper diagnosis. His visit to one of the major health facilities in the state revealed a diagnosis of TB and he was immediately started on treatment. Tasiu completed his treatment regimen for pulmonary TB with interruptions from time to time due to the strike action embarked upon by health care workers at that time.
His albeit latent TB was to erupt again sometime in 2011. He started noticing the same symptoms he thought he had dealt with in the past, causing him to return to the same hospital. The health care worker who received him saw no other option but to refer him to the teaching hospital for further review. TB was confirmed the second time and he was started on treatment with category 2 (CAT2) anti tuberculosis drugs. He completed this second round of treatment but alas his nightmare was far from over. Tasiu was yet to be free from the shackles of tuberculosis.
In December 2013, Tasiu’s fever returned with an intenseness he had never experienced. He was restive and grossly uncomfortable. He lost appetite and started losing weight rapidly. His cough was more aggressive and his sputum was sometimes stained with blood. He was continually tired and could hardly do any work. It dawned on him that this might yet again be the dreadful TB he had been battling with. The fierceness with which it was ravaging his body filled him the foreboding feeling that this time around, this was no ordinary TB. His greatest fear was confirmed when he got to the hospital in January 2014 and was speedily referred to the Infectious Disease Hospital (IDH), Kano, where he would have access to a new testing technique called GeneXpert.
After his sputum sample was collected and tested, he was informed that he had developed multi drug resistant TB. The focal person from the state TB program informed him that he would be included in the next cohort of patients and that he would require hospital admission for 8 months of the intensive phase of treatment with another new cocktail of medications. In the midst of his apprehension, he was finally relieved that the cause of his illness was now known and treatment was available. The down side for him was that the photography business he had started two months earlier would never see the light of the day.
Hope came for Tasiu, when a team from Family Health International (FHI360) and the State TB Program visited him at home within the same month and informed him that he could be enrolled into care while in his house. He was informed that United States Agency for International Development (USAID) had made funds available to support community MDR – TB patients like him and so would no longer need to wait for a bed space in IDH, Kano which happens to be the only treatment facility in the state. He was informed that a health care worker would be assigned to him to ensure he routinely takes and complies with the strict treatment regimen, nutritional and infection prevention requirements needed to guarantee a successful treatment outcome. He was told that this would be at no cost to him. As promised, after all necessary investigations, he was commenced on MDR- TB treatment which will run for a 20 month period.
To the amazement of Tasiu and his treatment supporter, he returned a smear negative result only after a few months on treatment and gradually regained his strength. With his closely monitored nutritional support, he started regaining lost weight and began once again to think of photography. With the 8 months intensive phase of his treatment completed, he is back to his first love – photography and has opened his own personal studio. He makes an average of N5, 000 to N6, 000 daily and can now contemplate starting a career in teaching at the end of his 20 month treatment regimen.
Tasiu’s treatment outcome resonates with the psych-social benefits of community based treatment for MDR-TB as patients are able to enjoy the comfort of their homes and companionship of their loved ones. The fact of not been isolated from family and friends allows them to quickly re-establish a source of income which can be used to sustain themselves and their families. This is the bedrock of our community MDR – TB program which continues to change lives in lasting ways.