TB Chronicles: An MDR/ XDR-TB champion

Dr Diana Wangari, CNS Special Correspondent, Kenya
How many people find it hard to complete an antibiotic dose that is probably one tablet a day for 5 days? Do you remember the last time the doctor said you needed to get an injection and you thought to yourself, surely there must be some other way and so you tried negotiating with the doctor? Now imagine having to take twenty-seven pills a day for not just 5 days but 2 years and on top of that a painful daily injection for 6 months? Take a moment and let that sink in.

You are probably thinking that you would not be able to manage it. But this is the reality that patients with multidrug resistant TB (MDR-TB) have to face. It would not be out of place to mention a little bit about this difficult form of TB. MDR-TB involves resistance to the two most powerful anti-TB currently being used-- isoniazid and rifampicin; while extensively drug-resistant TB (XDR-TB) includes resistance to at least four of the core anti-TB drugs as well as to one of the three injectable second line drugs.

Therefore, treatment of DR-TB takes a longer duration and requires use of second-line anti-TB drugs, which are more expensive and have more severe side effects than the first-line drugs used for treating drug-susceptible TB.

This is why when you get to hear stories of those who survived MDR or XDR- TB you cannot help but be inspired by their strength, for they represent candles in the darkness and whose moving stories ought to be shared if only they can provide solace as well as encouragement to other patients—that there is life beyond TB.

One such candle is Xolelwa Jowi who in 2012 was admitted to hospital only to receive a diagnosis of MDR-TB and a week thereafter for the diagnosis to be moved up to XDR–TB. She explained how the myth regarding XDR-TB at the time prophesied that you only had three days to live once you received such a diagnosis. And lying in bed at Fort Grey TB hospital in East London, she must have felt that her life had now been reduced to a ticking time bomb and the countdown had been initiated.

But Xolelwa managed to complete her treatment in 2013. Speaking to CNS, she said, “There are many a times that I felt like just giving up, and dying appeared to be the better option. But because of the support system around me from my doctors, hospital staff and peer educators I was able to take it- one day at a time. The need of a support system is sometimes overlooked in aspects of treatment, but it is fundamental and has to be part of the approach to treatment of MDR-TB patients.”

Currently, Xolelwa is already in the process of rebuilding her life successfully. After her treatment, she started working as a peer educator working with MDR-TB patients in the same hospital where she was once admitted. She is also studying to be a nurse at Lilitha Nursing College, attached to Butterworth Hospital in the Eastern Cape, South Africa hopes to become a professor and one day.

And if you think that her strength could not be more inspiring, it could. Xolelwa lost her twin sister to MDR-TB. You can say, she literally lost her other half and yet she goes on being an ambassador of hope to MDR/XDR- TB patients. Do you still think that getting that injection the next time your doctor prescribes it, is hard?

Dr Diana Wangari, Citizen News Service - CNS
3 December 2015
(Dr Diana Wangari MD, is providing thematic coverage from the 46th Union World Conference on Lung Health in Cape Town, South Africa, with kind support from Lilly MDR TB Partnership. Follow her on Twitter: @diana1wangari)