Eliminate the TB Scourge

May 20, 2016

By Uvistra Naidoo

It’s 1 a.m. A young mother approaches me during my hospital shift. She asks if her 2-year-old son will survive the night. He has been given a diagnosis of severe tuberculous meningitis, months after her husband was found to have drug-resistant TB. We suspect the child acquired the infection from his father.

The mother was tormented by guilt and worried about her child’s future. The disease usually affects the lungs, but it can also strike the brain, kidneys and other parts of the body. How do I tell the mother that the fluid in her baby’s brain is terribly elevated and we need to drill holes into his skull to release the pressure? How do I tell her that, if he survives, he will probably have some brain damage and that the prospects that he’ll be able to lead an independent life are questionable?

For me, these moments are both a harsh reality and all too personal.

On Feb. 22, 2011, I was declared cured of a severe form of drug-resistant TB, which I contracted during my medical internship. It took three years, one week and one day for me to be released from the shackles of 23 tablets a day with additional intravenous medications.

I saw the fearful looks in my family’s eyes, wondering if I would make it through many a night. The fear was indistinguishable from what I see in the families of TB patients I treat today. Doctors and nurses resuscitated my ailing body, afflicted by almost every side effect known from the toxic drugs used to combat TB: Diffusely bleeding skin lesions. Liver inflammation. Severe limb pain and near immobility. Hearing loss. Depression and thoughts of suicide.

Since being cured, I have been forever changed. Odd as it may sound, I refer to TB as my greatest mentor in my work as a clinician and researcher against this scourge. But as I don my stethoscope each day, I also worry that this disease, caused by bacteria that can be spread through the air, will revisit my body.


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4 comments on “Eliminate the TB Scourge

  • 1
    Robert Firth says:

    A truly moving article. But …

    I wonder about the strategy of combating drug-resistant microbes by
    researching ever more drugs – to which the microbes will become
    resistant in microbe-evolution time, ie very quickly. That seems to
    be a Red Queen’s Race that humanity must inevitably lose.

    Is there a better way?

    When I lived in Africa, we attacked malaria not with drugs, not with
    insecticides, but with palm oil. Sprayed on the breeding grounds,
    it broke the surface tension that the larvae used to cling to the
    water surface, and they drowned. There is clearly no way they
    can evolve “resistance” to a physical principle. Is there any analogy
    in the micro world? I’m not competent to say.



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  • Robert Firth #1
    May 23, 2016 at 2:45 am

    I wonder about the strategy of combating drug-resistant microbes by
    researching ever more drugs – to which the microbes will become
    resistant in microbe-evolution time, ie very quickly. That seems to
    be a Red Queen’s Race that humanity must inevitably lose.

    The reason humanity is losing the war against antibiotic resistant bacteria, is commercial stupidity!

    Not only are some doctors inappropriately over prescribing antibiotics, but they are used in unhygenic animal meat production to promote growth and increase profits!
    In fact the bulk of antibiotic production is used on animals.

    https://www.statnews.com/pharmalot/2016/05/10/antibiotics-resistance-livestock-fda/

    The FDA was urged by consumer groups and lawmakers to take this step over concerns about antibiotic resistance, which has been blamed for some 2 million illnesses and 23,000 deaths in the United States, according to the Centers for Disease Control and Prevention. About 70 percent of antibiotics used to treat Americans are also used in livestock, according to the Natural Resources Defense Council.

    Until now, the FDA has not had access to specific information showing how antibiotics are used by food producers. An annual report issued by the agency tracks only total usage of different types of antibiotics in food-producing livestock. The latest report found a 4 percent gain from 2013 to 2014, and a 22 percent increase between 2009 and 2014

    As with your earlier suggestion, better hygienic stock rearing eliminating extensive anti-biotic use, would be the intelligent course of action, but commercial organisations resist this!
    The potential dangers of resistance, have been known since the 1960s!



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  • FWIW, I hoping to become involved in bulk algal cultivation. It is being promoted as a way to facilitate a livestock industry move away from dependence on antibiotics, with a ton of other benefits.

    http://www.wattagnet.com/articles/25821-livestock-feed-industrys-interest-in-algae-surges

    Alan’s point concerns one of the very great shames of American agribusiness. Labelling of antibiotic use is not required and when given is an uregulated “greenwashing” farce.

    article link follows in ten minutes



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