Edwige – Côte D’Ivoire

The name of the child in this story has been changed to protect confidentiality.

Edwige, nine years old and HIV-positive, began to experience symptoms of illness at the end of November 2011. She was diagnosed with TB the first week of December 2011. Previously, Edwige’s mother had been diagnosed with TB. Edwige was treated with first-line drugs, but did not show signs of improvement. Her doctor performed molecular DST and, in May 2012, diagnosed Edwige with MDR-TB. Her strain of TB was resistant to isoniazid and rifampicin, the two most powerful first-line drugs.

Even though Edwige was diagnosed with MDR-TB seven months earlier, in December 2012 she was still waiting to start treatment. The hospital that Edwige’s doctor works at has a list of 258 patients waiting for second-line drugs. Both the Both the Cote d’Ivoire government and the Global Fund purchase second-line drugs for TB patients in Côte d’Ivoire, but the Global Fund drugs are delayed, and there are only 50 treatment kits available in the country. Edwige’s doctor knows that the drugs they ordered will not be enough to treat all of their patients.

Edwige’s mother passed away in 2012 and left her daughter waiting to initiate treatment. If desperately needed second-line drugs do not arrive soon, it is possible that Edwige will lose her fight with TB and share her mother’s fate.

Story Collected by: Serge Agbo, MD, MPH, Elizabeth Glaser Pediatric AIDS Foundation, Washington, D.C.; Clement Adje Tchomian, MD, Elizabeth Glaser Pediatric AIDS Foundation, Côte d’Ivoire; Adadé Olivier, MD, National TB Program (PNTL), Côte d’Ivoire