By Mohammad Kaykuzzaman, Naoshin Afroz, Zakia Sultana, and Tristan Bayly.
Photos: Samuel Murmu
Unbeknownst to his family, seven-month-old Rahat from Dhaka, Bangladesh, had already been exposed to tuberculosis (TB). He got it from his grandfather who had recently died of the disease.
The first signs of trouble came when Rahat, a normally happy baby, stopped smiling. He lost the usual playfulness of a healthy child, rapidly lost weight, and developed a large swelling on the side of his neck. His parents were very worried, as they knew that this type of swelling was a possible sign of TB.
His parents went to the pharmacy and purchased some antibiotics to treat his symptoms, but his condition continued to worsen each day. They sought help at the Dhaka Population Services and Training Center, where Rahat was referred to the National Institute of Chest Disease and Hospital (NICDH). There, the doctors used a special diagnostic method called fine needle aspiration cytology to find out what was wrong. Rahat’s parents learned the terrible news: their ten-month-old son had TB.
Rahat was immediately started on treatment, but after two months his condition had not improved. He was taken back to the NICDH, but this time he went to the drug-resistant TB unit. There, a team of experts trained and supported by the USAID-funded Challenge TB project assessed Rahat’s response to treatment and he was tested using GeneXpert. This test confirmed that Rahat was suffering from drug-resistant TB, which is why the initial course of treatment had had no effect.
“I will never forget the 12 of July, 2016. That was the day the doctor told me that my child had drug-resistant TB. I walked home from the hospital in a state of bewilderment and shock. How could my child have drug-resistant TB?” — Rahat’s mother, Nasrin
Given how young Rahat was and the fact that he only weighed seven kilograms, the team of doctors treating him were justifiably worried that he would not be strong enough to fight this devastating disease. To give him the best possible chance of survival, they set up community-based treatment that allowed Rahat to receive his medicines at home and to continue being breastfed by his mother.
Challenge TB’s community TB coordinators closely monitor his condition and treatment through regular home visits and a mobile phone app called mHealth developed by Challenge TB. The app allows the coordinator to easily track both the treatment and the DOT provider, in order to ensure that TB patients like Rahat are getting their daily medicine and whether they are suffering from any adverse side effects.
With financial support from Challenge TB to cover the costs of check-ups, tests, and nutritious food, Rahat’s life has been restored. His treatment will take another three months to complete, but he put on 3 kg of weight after just two months, and he is already back to his former self. He is not only smiling again, but he is active and playing like any other child his age.
Finding more children with TB is a high priority for the Challenge TB project in Bangladesh. In 2017, more than 240,000 children were screened for TB at six selected facilities and a total of 404 were found to have TB and put on treatment. Twenty-seven children with drug-resistant TB have also been diagnosed since 2016, all of them have been treated and are doing well.
For more information on Challenge TB visit www.challengetb.org
Challenge TB is a USAID-funded project that aims to prevent the transmission and disease progression of TB, improve patients’ access to TB care services, and strengthen TB platforms. Management Sciences for Health (MSH) is part of the consortium implementing the project and leads the project’s activities in Bangladesh.