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Harrowing tale of first XDR-TB victim in Kenya

Elizabeth Wangeci is a picture of perfect health. As she cuddles her three-month-old baby Paul Murigi, his sibling John Machira playful tickles him in Toll area, Ruiru.

It is difficult to imagine that just four years ago, she is a woman who had lost all hope in life. Wangeci, a mother of three, was the first patient to be diagnosed with Extensively Drug Resistant TB (XDR-TB) in Kenya.

This is a rare type of multidrug-resistant tuberculosis (MDR-TB) on which two of the most powerful first-line anti-TB medication; isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs such as amikacin, kanamycin, or capreomycin are ineffective against.

“I was a Class Two and Three teacher at Stellarm Elite school in Mathare North slum and one day, I woke up with flu symptoms. I did not think much of it and assumed it was a result of inhaling too  much chalk dust in class and it would go away, but it never did,” she says.

When the flu persisted, this time with severe sore throat, she resorted to over-the-counter medicine. But the condition worsened.

She went to hospital and demanded to have a TB test done but the doctor at Mathare North City Council hospital said she did not display any symptoms of a TB patient and prescribed antihistamines.

“I did not get better. I started losing weight; my complexion changed to a lighter shade and the cough was uncontrollable. My boss, told me to take days off and get myself properly checked,” she reminisces.

When she went back to the hospital, Wangeci demanded that they do a TB test. They did, and the results were positive. She was put on medication for several months. Nothing changed.

“I remember the doctors at the clinic were angry and accused me of not taking my medication as prescribed, but as a teacher, and knowing what I was suffering from, I could not afford to skip a single tablet,” she says.

A doctor at Kenyatta National Hospital referred her to Medecins Sans Frontieres (MSF), an international medical humanitarian organisation. Another test revealed she had MDR-TB.

She had to abandon her six-year teaching career to concentrate on treatment. After several months of medication, she had not improved, and her condition moved to the third and most critical level, XDR-TB.

This strain of TB could arise from improper use of antibiotics, including use of improper treatment regimens or improper dosage which could include failure to complete treatment, or transmission of this strain of TB through inhalation of the bacteria according to World Health Oganisation (WHO).  This new borderline strain of TB had not been diagnosed on anyone else in the country before.

After days of research, Doctors Without Borders at MSF administered Bedaquiline, a new experimental  drug, combined with other conventional TB medicines.

Her son, Machira, who was then two-year-old, exhibited symptoms of XDR-TB as well, which compelled the doctors to also put him to half-dose treatment.

“I was advised to bring my son for screening and he too turned positive. He was weak but after taking the medication for six months, he got better,” she said.

But her situation was not improving despite going to the clinic every morning to get an injection and pills for six months.

Besides, the drugs had serious side effects. She felt weak, extremely cold and sickly. Her skin complexion became dark and she could barely walk.

“I was giving up. The 13 pills I took daily always stuck in my throat and threatened to come out. I was tempted to stop them, after all, I was not getting better and some patients I knew had passed on. But doctors at the clinic, family and friends encouraged me to continue with the treatment,” she says.

Her son on the other hand was also affected by the strong medication delaying his milestones.

Wangeci is glad that eventually, she started improving and at some point the injections stopped. She completed taking her medication in June 2016 and her health has improved since then.

Today, two years after receiving a clean bill of health, Wangeci and her son are as fit as a fiddle.

She is grateful to the government for the incentives she was given during the times she was on treatment.

“We received Sh12,000 every month allowance to help take care of ourselves and also facilitate out journeys to hospital every morning for medication,” she said.

As the world celebrates World TB Day tomorrow, Wangeci stands as a beacon of hope that one day, Kenya will be free of the debilitating disease.

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