TB is not a death sentence for people living with HIV
By, Kakaire A Kirunda, The Daily Monitor (uganda), May 22, 2007
"WHILE HIV PROGRAMMES HAVE ATTRACTED FUNDING, TB HAS MINIMAL FUNDING.
BUT THE INCREASING INTERACTION BETWEEN THE TWO DISEASES SHOULD HELP RAISE AWARENESS ON THE NEED FOR THE EMPOWERMENT OF COMMUNITIES TO TACKLE TB AS WELL. THERE IS NO REASON FOR PEOPLE LIVING WITH HIV/AIDS TO CONTINUE DYING OF TB"
Although preventable and curable, tuberculosis remains one of the most deadly infectious diseases in the world and it is the leading cause of mortality among people living with HIV.
When Erick Nangosya of Busiu in Mbale district discovered that he was HIV positive in 2004, he did not straight away embark on antiretroviral drugs. He was instead put on cotrimoxazole (Septrin) preventive therapy
(CPT) to ward off opportunistic infections.
But two years down the road in July 2006, Nangosya started feeling frequent fatigue and he sometimes slept without covering himself because of constant night sweatings. He even started having what he refers to as light coughs.
"I knew these were the usual treatable opportunistic infections.
However, two weeks into my leave in September, I started developing serious fever and started undergoing treatment in a clinic near home,"
Nangosya, a father of 12 children said. But his health continued to deteriorate by the day and he eventually lost appetite.
With no improvement in his health, Erick decided to seek further help from The AIDS Support Organisation (TASO) centre in Mbale where he is registered. Tests were carried out and it was discovered that he had pulmonary tuberculosis.
Although preventable and curable, tuberculosis (TB) remains one of the most deadly infectious diseases in the world. And it has turned out to be the leading cause of mortality among people living with HIV/ AIDS.
Upon being diagnosed with TB, Nangosya was in October 2006 put on critical treatment for two months. "It was really hard. TB treatment involves taking many big tablets. I was put on some capsules which were so bitter and yet I had to open the capsules and chew the powder.
It was a very hard moment. But considering that I had to secure my life, I had to persist and follow the medical advice," Nangosya recalled.
Two weeks into the eight-month road, Nangosya registered a dramatic improvement. However, worth noting is that it is usually at that stage of treatment that some TB patients start skipping daily dosages because of complacence. Some patients either interrupt their treatment because they feel better or imagine that they no longer need the drug.
This results in mutations leading to drug-resistant bacteria that complicates the recovery process and sometimes death.
STAYING ON TREATMENT
So how has Nangosya managed to hang on to treatment to date?
"I hang on for the sake of my life because I know that TB is a killer disease. I was going to die so I had to force myself back to life. I was forced to take treatment as prescribed. But all in all, I should say that adherence to treatment has played a big role in my steady recovery."
Nangosya is set to complete his treatment at the end May 2007. He said that when a person is undergoing TB treatment, family support as well as care by colleagues at the work place is vital for patients co-infected with HIV and TB. "My wife did a lot and was very courageous. You become forgetful. My wife became part of me so she kept reminding me to take my medicine. Also my workmates at TASO committed themselves towards seeing me improve."
And given that volunteers who would help people living wth TB and HIV in communities take their daily dosages were abandoning the cause, Nangosya said that the family support needed strengthening. He suggested that even if this meant the government giving handouts to families of people living with TB, so be it.
"Much as friends can help, they can't be around all the time. And it would be unfair to keep them off their work just to come and remind you to take your medicine. It would be easier done by a family member," he said.
However, Nangosya does not completely ignore the role of the community in the fight.
"What is failing the community response is funding. While HIV programmes have attracted funding, TB has minimal funding. But the increasing interaction between the two diseases should help raise awareness on the need for the empowerment of communities to tackle TB as well. There is no reason for people living with HIV/AIDS to continue dying of TB."
While Nangosyas' story raises important issues in TB management, a lot of stigma still surrounds the disease given its infectious nature.
IGNORANCE OF PEOPLE
"It is ignorance of people who have TB. What they ought to know is that once a patient finishes treatment for the first two weeks, they no longer constitute a threat to public health," he said.
"And people should also remember that thousands of others are living with the infection and are potential candidates for the disease once their immunity is compromised."
None-the-less, Nangosyas is suggestive of giving former and current patients a platform to talk about their treatment so as to convey to potential casualties that TB can be cured and that the disease does not discriminate, thus eliminating social stigmas associated with it.
Online at: http://www.monitor.co.ug/socpol/socpol05222.php
"WHILE HIV PROGRAMMES HAVE ATTRACTED FUNDING, TB HAS MINIMAL FUNDING.
BUT THE INCREASING INTERACTION BETWEEN THE TWO DISEASES SHOULD HELP RAISE AWARENESS ON THE NEED FOR THE EMPOWERMENT OF COMMUNITIES TO TACKLE TB AS WELL. THERE IS NO REASON FOR PEOPLE LIVING WITH HIV/AIDS TO CONTINUE DYING OF TB"
Although preventable and curable, tuberculosis remains one of the most deadly infectious diseases in the world and it is the leading cause of mortality among people living with HIV.
When Erick Nangosya of Busiu in Mbale district discovered that he was HIV positive in 2004, he did not straight away embark on antiretroviral drugs. He was instead put on cotrimoxazole (Septrin) preventive therapy
(CPT) to ward off opportunistic infections.
But two years down the road in July 2006, Nangosya started feeling frequent fatigue and he sometimes slept without covering himself because of constant night sweatings. He even started having what he refers to as light coughs.
"I knew these were the usual treatable opportunistic infections.
However, two weeks into my leave in September, I started developing serious fever and started undergoing treatment in a clinic near home,"
Nangosya, a father of 12 children said. But his health continued to deteriorate by the day and he eventually lost appetite.
With no improvement in his health, Erick decided to seek further help from The AIDS Support Organisation (TASO) centre in Mbale where he is registered. Tests were carried out and it was discovered that he had pulmonary tuberculosis.
Although preventable and curable, tuberculosis (TB) remains one of the most deadly infectious diseases in the world. And it has turned out to be the leading cause of mortality among people living with HIV/ AIDS.
Upon being diagnosed with TB, Nangosya was in October 2006 put on critical treatment for two months. "It was really hard. TB treatment involves taking many big tablets. I was put on some capsules which were so bitter and yet I had to open the capsules and chew the powder.
It was a very hard moment. But considering that I had to secure my life, I had to persist and follow the medical advice," Nangosya recalled.
Two weeks into the eight-month road, Nangosya registered a dramatic improvement. However, worth noting is that it is usually at that stage of treatment that some TB patients start skipping daily dosages because of complacence. Some patients either interrupt their treatment because they feel better or imagine that they no longer need the drug.
This results in mutations leading to drug-resistant bacteria that complicates the recovery process and sometimes death.
STAYING ON TREATMENT
So how has Nangosya managed to hang on to treatment to date?
"I hang on for the sake of my life because I know that TB is a killer disease. I was going to die so I had to force myself back to life. I was forced to take treatment as prescribed. But all in all, I should say that adherence to treatment has played a big role in my steady recovery."
Nangosya is set to complete his treatment at the end May 2007. He said that when a person is undergoing TB treatment, family support as well as care by colleagues at the work place is vital for patients co-infected with HIV and TB. "My wife did a lot and was very courageous. You become forgetful. My wife became part of me so she kept reminding me to take my medicine. Also my workmates at TASO committed themselves towards seeing me improve."
And given that volunteers who would help people living wth TB and HIV in communities take their daily dosages were abandoning the cause, Nangosya said that the family support needed strengthening. He suggested that even if this meant the government giving handouts to families of people living with TB, so be it.
"Much as friends can help, they can't be around all the time. And it would be unfair to keep them off their work just to come and remind you to take your medicine. It would be easier done by a family member," he said.
However, Nangosya does not completely ignore the role of the community in the fight.
"What is failing the community response is funding. While HIV programmes have attracted funding, TB has minimal funding. But the increasing interaction between the two diseases should help raise awareness on the need for the empowerment of communities to tackle TB as well. There is no reason for people living with HIV/AIDS to continue dying of TB."
While Nangosyas' story raises important issues in TB management, a lot of stigma still surrounds the disease given its infectious nature.
IGNORANCE OF PEOPLE
"It is ignorance of people who have TB. What they ought to know is that once a patient finishes treatment for the first two weeks, they no longer constitute a threat to public health," he said.
"And people should also remember that thousands of others are living with the infection and are potential candidates for the disease once their immunity is compromised."
None-the-less, Nangosyas is suggestive of giving former and current patients a platform to talk about their treatment so as to convey to potential casualties that TB can be cured and that the disease does not discriminate, thus eliminating social stigmas associated with it.
Online at: http://www.monitor.co.ug/socpol/socpol05222.php
posted by AIDS-Care-Watch at 9:54 am
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