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New hope for drug-resistant TB patients

2018-06-26 00:54

For Bukelwa Peter, a Port Elizabeth mother of three boys, feeling ice-cold in summer sounded a health alarm.

After multiple check-ups at her local clinic, she was initially diagnosed with multidrug-resistant tuberculosis (MDR-TB) and when sent for another test, with extensively drug-resistant tuberculosis (XDR-TB).

“I felt very cold. My feet were very painful and swollen at times, but I was not really coughing,” she said.

Peter was devastated when she had to move into a treatment centre in Port Elizabeth, away from her sons.

The medicines she takes have debilitating side effects: extreme nausea, deafness and kidney failure, and treatment periods of up to 24 months.

But now there is hope for South Africans like her, who constituted 10% of the world’s drug-resistant TB (DR-TB) patients in 2016.

Last week, the national health department introduced a world first: the roll-out of an oral medicine, bedaquiline, to DR-TB patients.

The drug has been found to effectively treat adolescents and adults with fewer side effects.

The department tested the drug’s efficacy on 200 patients through the two-year Bedaquiline Clinical Access Programme study.

Reflective analysis on the group which received bedaquiline showed that three in four patients were cured, while one in two died during treatment – a much lower rate than patients who did not receive it.

In the past seven years the department has increased the number of MDR-TB treatment initiation sites from 17 to 636.

Of these, 291 are already providing bedaquiline to some patients.

The department’s Norbert Ndjeka said it now has to roll out the drug to the rest within the next three to six months.

“The use of bedaquiline among MDR-TB patients has shown a 41% increase in the treatment success rate and threefold reduction in the death rate.”

For many years, Ndjeka said, the public health system took two years to treat DR-TB: six months of daily injections and oral antibiotics followed by an 18-month continuation phase.

Peter’s treatment centre is yet to provide bedaquiline to patients, which could have made the side effects of the initial stages of her treatment with injectable drugs easier.

“I used to lose my appetite and I was nauseous after taking my medication. Sometimes I would not eat for about five days except for a nibble here and there. I also had back pain,” said Peter.

Three months later she is over the worst and her doctors say her lungs are in far better shape.

She is grateful she’s not a death statistic.

“Some people have it hard here,” she said. “What I miss the most about being here are my three beautiful sons and I pray to God every day for strength.”

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June 23 2019