In-depth: The New face of TB: Drug resistance and HIV

SOUTH AFRICA: "But how could it be TB?"

Photo: Sida-Alternag
JOHANNESBURG, 23 March 2007 (PlusNews) - Fear of stigma and ignorance still prevents scores of South Africans from seeking early diagnosis and treatment for tuberculosis (TB), even if the drugs are now more freely available from the public health system.

For Natasha Mathews, 25, this fear of discrimination and lack of awareness almost resulted in death.

"Three years ago I picked up a persistent cough, but thought nothing of it at first, as people [at work] were always sniffing or coughing because of the air-conditioning. I suspected that the cough might also be related to the fact that I smoked about six cigarettes per day but, a couple of weeks later, it [the cough] was still there.

It's almost funny how we never take our ailments seriously and sometimes even consider them to be normal. Before I knew it, the coughing had become such a part of me that I barely even noticed it, and neither did the people I worked with ... or maybe they were just too embarrassed to state the obvious.

Things at home were starting to get tense though. I shared an apartment with a friend, and even though we had separate bedrooms, I could sense that he was mildly irritated, mainly because he was HIV-positive and had recently began taking antiretroviral drugs and feared it [my coughing] could be TB.

But how could it be TB? After all, only poor people got TB and I earned a fairly reasonable salary and lived in a nice apartment and ate three meals daily and exercised.

My roommate ... finally plucked up the courage to suggest that I get tested but, even then, his advice fell on deaf ears. As months passed and the coughing grew worse, and was accompanied by even more intense night sweats, I decided to take time off work to seek medical advice.

Two private doctors and a small fortune later, I was back at work treating my cough with antibiotic tablets. Neither of the doctors seemed to think it was TB. And how could they? Aside from the cough and night sweats, my appetite was fine and my weight was constant.

Then one day at work, during a function, I suddenly became quite nauseous and dizzy. I barely managed to grab a dustbin before I started vomiting up huge clots of blood.

I spent two weeks at Johannesburg General Hospital, where doctors ran a battery of tests. Only when all their options were exhausted did they ask for my permission to do a joint TB and HIV test. By then I was so ill that refusal was not an option. I was afraid for my life.

He [the doctor] diagnosed 'severely active TB and considerable damage and bleeding in both lungs' ... but at least I was HIV-negative.

As a sexually active single woman, I always prioritised condoms and safe sex, but with everything you hear about TB being the main killer of people living with HIV, I felt a little anxious as I waited for my results.

I was released from the hospital's TB unit with two week's supply of medication, which amounted to three tablets three times a day over six months, and a whole lot of 'unpaid' leave to make sure that I recovered properly and came into contact with as little people and co-workers as possible.

The call centre had to be notified about my situation, and also make time for all of the staff to be tested for TB as well. My roommate got tested too. He was angry with me for letting my illness progress that far, but luckily he tested negative. I hear people with HIV often have little chance of recovering from simultaneous infection with the two.

I will never know who gave me TB, or even how many people I infected in return, because people are always coughing and sniffing."


This report is part of a PlusNews In-depth: 'The New face of TB: Drug Resistance and HIV'
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