The name of the child in this story has been changed to protect confidentiality.
Cordaro, an HIV-positive and malnourished seven-year-old, began experiencing symptoms of illness in December 2011. A full year after his symptoms first started, Cordaro was diagnosed with TB. He began taking first-line TB drugs with his HIV medications, but had trouble adhering to his treatment regimen.Cordaro struggled with the side effects of his TB medications. Eventually, poor treatment adherence resulted in Cordaro’s strain of TB developing resistance to some of the TB medications he was being treated with.
Using gastric aspiration, Cordaro’s doctors were able to obtain a culture for DST. In May 2012, five months after initiating treatment with first-line drugs, Cordaro’s doctors determined that his strain of TB was resistant to isoniazid and rifampicin, the two most powerful first-line drugs. Cordaro was diagnosed with MDR-TB. At the time of his MDR-TB diagnosis, Cordaro was discriminated against and stigmatized by his health care providers because he was HIV-positive. Cordaro’s father believes that if Cordaro’s health care providers had received sensitivity training, his son would not have experienced stigma and discrimination at the health care facility and would have received better quality care.
The health institution was overburdened with patients, and as a result, Cordaro’s doctors could not start him on second-line TB drugs for four months. Cordaro’s health was declining, a direct result of TB/HIV coinfection. Cordaro was admitted to the hospital with respiratory complications, excessive sweating, shortness of breath, fever, and opportunistic infections. While receiving treatment, Cordaro became depressed and his sense of taste changed. He also experienced liver and kidney damage, likely caused by the toxic second-line drugs he was taking. Unfortunately, public health insurance only covered some of the health services Cordaro desperately needed, the others were too expensive for Cordaro’s family. As a result, Cordaro was denied necessary health services, adversely affecting his quality of life during treatment.