The Sunday Mail
Shamiso Yikoniko recently in Zvishavane
Incessant coughing had become the order of day for 26-year-old Ms Irene Mugova of Zvishavane. Struggling to breath and speaking in wheezy whispers was the norm, as she endured stigma from a community that did not want to catch whatever ailed her.
Health experts have concluded that MDR-TB is resistant to isoniazid and rifampicin, the two most potent anti-TB drugs.
Adding to her woes was the sudden weight loss.
She visited Zvishavane District Hospital, where she was told that she had contracted multi-drug resistant tuberculosis (MDR-TB).
She had been treated for TB last year and subsequently tested negative.
“After suffering from a number of symptoms I then decided to visit Zvishavane hospital where the nurse took my sputum and a few hours later I was told that I am suffering from multi-drug resistant tuberculosis,” she explained, almost in tears.
“I couldn’t believe and still can’t even though I started the treatment for multi-drug resistant tuberculosis in March this year. I asked myself what is it about me that I suffer from two episodes of two different strains of TB?”
MDR-TB is caused by mycobacterium tuberculosis that has developed a genetic mutation so that particular drugs are no longer effective against the bacteria.
Health experts have concluded that MDR-TB is resistant to isoniazid and rifampicin, the two most potent anti-TB drugs.
While drug-resistant TB is usually blamed on patients who do not adhere to TB treatment and consequently develop resistance, Ms Mugova had completed her TB treatment and was cured.
She was unfortunate to get into contact with the resistant bacteria coughed up by someone infected with it, a factor that explains the surge of the disease in the country.
Zvishavane district TB co-ordinator, Mr Nkulumo Ncube, explained that there are two main forces that drive the drug-resistant TB outbreak.
“The first is generation of drug-resistant TB through mismanagement of patients being treated for pan-susceptible disease and the second is ongoing transmission of drug-resistant TB in the community,” he said.
When a nurse started visiting her house to inject while her wearing a mask, Ms Mugova’s neighbours became afraid of her, fearing they too would be infected.
But Ms Mugova’s greatest worry is nutrition since the medication requires that she eats healthy.
“The tablets and injections that I’m taking require that I constantly eat nutritious food for them to work well and not give me pain but the problem is I don’t go to work and cannot afford the recommended diet,” she said.
“Besides, my condition doesn’t allow me to socialise as I’m expected to be in isolation till my sputum tests negative again. And so getting nutritious food is a struggle for me. My sister who has a family of her own assists me with rentals and food.
“I’m trying my best to protect my family and other people from contamination so I no longer go to church, attend gatherings or hang out with friends.”
The Global Fund to fight HIV and Aids, TB and Malaria pays drug-resistant TB patients a monthly allowance to supplement their diets.
“Even though it’s a noble initiative, I still feel that US$25 being donated to multi-drug resistant TB patients is too little considering our dietary requirements,” said Ms Mugova.
Health experts say that poor nutrition is common among people with active TB.
The disease may lead to underweight and micronutrient defiencies by increasing energy requirements, poor metabolism and loss of appetite.
While she is expected to be in isolation during the intensive care or at least in a well-ventilated house, Ms Mugova stays in a one-roomed house with her two-year-old child.
The nurse managing Ms Mugova, who cannot be named for professional reasons, says she is afraid of being infected too, but that will not stop her from doing her job.
“Anyone who is contact with a multi-drug resistant tuberculosis patient with a positive sputum is at risk of contracting the disease, hence you see me wearing a mask when I administer treatment to them,” she explained.
Ms Mugova’s life reflects that of over 800 drug-resistant TB patients on treatment across the country.
Zvishavane district medical officer Dr Timothy Muvurayi told journalists during a Global Fund Midlands tour that they have about 12 drug-resistant TB patients on treatment.
Dr Muvurayi said lack of isolation space for patients was a challenge as this stymied efforts to curb contagion.
“If we could have them hospitalised during the first six months or at least until there is negative sputum, this would help us manage and keep them in treatment,” he said. “The introduction of GeneXpert machines in hospitals has helped increase detection hence we now have more patients on treatment.
“This district, due to the high mining activity, was prioritised to have a GeneXpert machine and it has really helped.”
According to health experts, treating drug-resistant TB is a consuming and expensice two-year process.
So while Government and its partners seek other drug-resistant TB management systems, Ms Mugova will continue with her two-year treatment.
Midlands acting provincial medical director Dr Mary Muchekeza said they were looking forward to trans-frontier collaboration to combat multi-drug resistant tuberculosis.
