KAMPALA, 20 March 2008 (PLUSNEWS) - Becky Mugisha* had been ill with a hacking cough for three months before she was admitted into one of Kampala's busiest tuberculosis (TB) wards, but she recognised the symptoms long before that. It was her second bout with the disease.
The last time Mugisha had had TB, about a year before, she was put on a sixth-month course of treatment. As a person living with HIV, she was used to taking multiple pills on a daily basis, but she failed to complete her treatment because the dispensing clinic where she lives in Wakiso, just east of Uganda's capital, Kampala, ran out of the drugs. Mugisha's compromised immune system and treatment history made her susceptible to infection with multi-drug resistant TB (MDR-TB), a strain of the disease that requires more expensive and extensive treatment and affects 4.4 percent of TB patients in Uganda who have previously been treated for the disease, according to the World Health Organisation (WHO). Now Mugisha is receiving inpatient treatment at the TB unit in Mulago Hospital, Kampala's main referral hospital. While many hospitals and health centres outside Kampala can treat TB, few can handle MDR-TB cases that often require long hospital stays.
JOHANNESBURG, 25 March 2008 (PLUSNEWS) - Another hospital breakout in South Africa by drug-resistant tuberculosis (TB) patients desperate to spend the holidays with their families has some public health experts questioning whether forced isolation is either the most effective or humane way to treat such patients.
On Thursday, 25 patients with multi drug-resistant (MDR) TB and eight with extensively drug-resistant(XDR) TB pushed their way past guards at Jose Pearson TB Hospital in Port Elizabeth, in the Eastern Cape. By Monday, 21 of them had returned, most of them voluntarily, four as a result of court orders.
MDR-TB is resistant to the two most powerful anti-TB drugs, while XDR-TB is resistant to these and at least two others. Whereas non-drug resistant TB is treated on an out-patient basis with a six-month course of drugs, South Africa's policy is to treat drug-resistant TB patients as in-patients until they are no longer infectious. XDR-TB patients, who are the most difficult to treat and pose the greatest public health risk, are required to spend up to two years in hospital, isolated from their families and facing the very real possibility that they will die before being released.
NAIROBI, 2 April 2008 (PLUSNEWS) -
Caption: The national referral hospital has already seen seven new cases of MDR-TB from one IDP camp in the capital, Nairobi
The threat of multi-drug resistant tuberculosis (MDR-TB) has been heightened by the displacement of an estimated 300,000 people in Kenya's recent political crisis, health workers have said.
"During the violence, many displaced people were disrupted from their lives, which meant disruption from drugs," said Dr Henderson Irimu, head of the HIV/TB treatment care at the Kenyatta National Hospital, the country's largest referral hospital. "Due to the violence it was impossible for people to come for medication."
Irimu said there had been an increase in MDR-TB, a form of the disease that does not respond to standard treatment, usually because of a failure to complete first-line treatment. When patients are co-infected with HIV, it is often lethal.
"So far we have seven new cases of MDR-TB who were brought at the hospital from Mathare internally displaced settlement [in the capital, Nairobi]," he said. "Some would come and admit to not having taken TB medication since the violence began."
"Patients who were found to have developed resistance to first line medication require to be treated in isolation for a period of four months to reduce the spread, but there is a need for a special clinic or ward facility for MDR-TB," he added.