Getting the TB Diagnosis Right

“If you don’t come soon, you may never see me and the baby alive again!” That is all Nyakato could say over the neighbor’s cellphone to her older sister Beatrice.

Nyakato and her two year old daughter, Ahabwe, were in the grip of a debilitating illness that was causing both to waste away. Ahabwe was so weak that she could hardly hold her head up.

Nyakato’s husband had recently died from an AIDS-related illness. As a person living with HIV, Nyakato knew her health was a priority and orphaning her remaining children was not an option. Nyakato was prescribed antibiotics at a clinic near her home in rural Southwest Uganda, but she didn’t feel any progress, in fact her symptoms worsened.

“I would feel something grab me in my chest, and then I would cough and cough and all the stuff inside was so bad,” says Nyakato. “I could hardly walk. In the evening I just lay there—I was sure I would die.”

In the bustling city of Mbarara, Nyakato’s sister, Beatrice, heard a message on the radio about TB—that it started with a persistent cough and that people living with HIV were vulnerable to TB. Beatrice thought that perhaps this was the illness attacking her sister and niece. Beatrice figured that the Mbarara Regional Referral Hospital might be able to save Nyakato. It is one of the 235 TB diagnostic and treatment centers supported by EGPAF.

The family pooled resources to transport Nyakato to the hospital, where she was diagnosed with TB and referred to a supporting rural clinic—Rwashamaire Health Centre, which is close to her home. The hospital clinician used Xpert MTB/RIF to confirm her diagnosis. Nyakato started her medication and her health rapidly improved. The clinicians also started the tracing process, figuring out who in Nyakato’s life might be exposed to TB.

Sure enough, her baby, Ahabwe, tested positive. “This was no simple achievement [to diagnose the baby],” says Sister Marion Nahabwe, TB Focal Person. “Little children are harder to diagnose because they don’t cough up sputum easily, and even when they do it’s not enough to test with and you may easily misdiagnose. So we checked her urine, using TB-LAM diagnostics, to screen for active TB.” Now Ahabwe is on her third month of anti-TB drugs.

Recently, Nyakato reached out to one of her friends who has been coughing for a while, urging her to see the doctor and check for TB. She tells anyone who cares to listen about how her life was saved as she watches her baby holding her head high, interested once more in everything around her.