Catherine Nduta smiles radiantly, her face glowing, the picture of perfect health, an image that speaks nothing of the pain and suffering she endured after contracting multidrug-resistant (MDR) TB early in 2012.
Despite having been successfully treated at Kenyatta National Hospital, what remains of the experience are memories that she would rather forget, but she is sharing her story in the hope of increasing awareness about the condition.
One year of daily drug injections and two years of swallowing 18 tablets of different drugs every day had become the life of this 26-year-old mother of one.
MDR-TB is highly infectious. The strain resists the normal six-month TB treatment and can take up to two years for an infected person to complete treatment.
It can either be contracted directly from an infected person or is the result of the progression of active tuberculosis; Catherine contracted it directly.
LUCKY TO BE ALIVE
“I feel so lucky to be alive,” says a smiling Catherine as she recalls her journey to health.
At the time of the diagnosis, the then third-year civil engineering student at a Nairobi college was pregnant, further complicating her case.
“When I started coughing, it did not occur to me at once that it was TB,” she says. But the cough was persistent and was accompanied by high fever, forcing her to seek medical attention, but the cough persisted even after she had taken medication for a week.
“My body became weak and I lost my voice for a whole month. At night, I would sweat profusely. I eventually went back to hospital and got a chest X-ray, and even had my throat examined. After the results came back positive for TB, I was put on normal TB medication,” she says.
Four months into treatment, she had no idea she was suffering from a rigid strain of TB after it was confirmed to her yet again that she still was sick despite a rigorous treatment.
Catherine was tested for a fifth time and it was at that particular point that she was diagnosed with MDR-TB, a strain of tuberculosis that can only be treated fully after 18-24 months, forcing her to stop TB medication midway.
But she could not start the treatment for MDR-TB immediately, because she was pregnant.
“When I went to Kenyatta on the advice of my doctors at Mbagathi, I was given two options, to either abort my baby or wait for the treatment to be started after delivery. But I was too weak to make the decision,” she says.
The doctors, upon her consent, eventually decided to induce her into labour in an effort to save her life. Mother and son survived the ordeal, but she did not see him for a month after she gave birth as she had to be kept in isolation.
“I used to cry every day, every night because of the isolation. But despite the danger of being in physical contact with me, my parents would still insist on seeing me because they knew no peace from my incessant calls,” she adds.
Catherine's mother and her three-year-old son. PHOTO | COURTESY
Catherine's mother and her three-year-old son. PHOTO | COURTESY
But her ordeal was just beginning. After being discharged a month later, she walked into the reality of one year of a daily drug injection and two years of swallowing 18 tablets of different drugs.
“At times I would feel so bad after the injection. I would stay like three hours feeling nauseated and out of the world. The drug would sap the little energy I had. I would feel like fainting, and I had to be assisted to stand or walk out after receiving it.”
It was her lifestyle, to wake up every day and travel to KNH, where she used to receive the treatment. But she appreciates that her doctor decided to transfer her treatment after one month to Kangemi Health Centre.
“He used to pack the drugs and bring them to Kangemi Health Centre, which is nearer my home. I had one challenge, though: I was so weak that I would spend like 30 minutes to walk a 10-minute distance. I used to look so confused, I felt crazy.”
Six months into the MDR-TB treatment, she started developing side effects. “My eyes turned yellow and I would not see clearly, my ears got blocked, people had to shout at me. My legs started swelling; it became a tall order for me to walk or to sleep. I felt so tired,” she explains.
Though the TB treatment is free in the country, she had no choice but to pay for her specialist treatment for her ears and eyes.
It was a relief for her to complete her treatment in August 2014, after two years of what she described as a horrendous experience.
She dropped out of the technical institute where she was studying, a few months before her final examinations.
“I could not be allowed near other students, plus I could not go to school with a face mask in addition to the fact that I was also too weak to do anything.”
After the treatment, she went back to school and started a new course, which she hopes to complete soon.
She thanks her parents, who were always there for her during that period. Her mother took the baby and nursed him after delivery. “I did not breastfeed my baby, it was hard to imagine. I saw him for the first time after a whole month, my father supported
me so much, he used to do everything for me. My mother left her teaching job to care for my baby.”
Her three-year-old son is her greatest motivation to surge on positively with life.
MORE INFORMATION ON MULTI DRUG-RESISTANT TB
Standard anti-TB drugs have been used for decades, and resistance to the medicines is widespread. Disease strains that are resistant to a single anti-TB drug have been documented in every country surveyed.
Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to, at least, isoniazid and rifampicin, the 2 most powerful, first-line (or standard) anti-TB drugs.
A primary cause of MDR-TB is inappropriate treatment. Inappropriate or incorrect use of anti-TB drugs, or use of poor quality medicines, can cause drug resistance.
Disease caused by resistant bacteria fails to respond to conventional, first-line treatment. MDR-TB is treatable and curable by using second-line drugs. However second-line treatment options are limited and recommended medicines may
not be always available. The extensive chemotherapy required (up to 2 years of treatment) is more costly and can produce severe adverse drug reactions in patients.
In some cases, more severe drug resistance can develop. Extensively drug-resistant TB, XDR-TB, is a form of multi-drug resistant tuberculosis that responds to even fewer available medicines, including the most effective second-line
About 480 000 people developed MDR-TB in the world in 2014. More than half of these cases were in India, the People’s Republic of China and the Russian Federation. It is estimated that about 9.7% of MDR-TB cases had XDR-TB.