Maleshoane – Lesotho

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

Maleshoane was considered a burden and abandoned by her mother at the Queen Elizabeth II public hospital in Maseru, Lesotho. Weighing just 55 pounds, with a collapsed lung, 13-year-old Maleshoane had been on ineffective treatment for tuberculosis for almost four years. Partners in Health learned of her case, and brought her to the national multi-drug resistant TB (MDR-TB) program.

Given Maleshoane’s numerous failed previous treatment courses, and her close contact with an MDR-TB suspect, her clinicians started her immediately on empiric treatment for MDR-TB. Partners in Health staff also counseled Maleshoane’s mother, who eventually took her back after two months of her MDR-TB treatment in the hospital. Six months into her MDR-TB treatment, her drug susceptibility testing results confirmed that Maleshoane did indeed have MDR-TB (resistant to three first-line drugs).

Maleshoane was eventually cured, but it took over two years of MDR-TB treatment. During this time, she experienced many serious adverse effects of treatment, including potassium deficiency, hypothyroidism, hearing loss and nerve damage. She also nearly lost her left lung to extensive fibrosis.

Maleshoane, now 15 and healthy, is a living testament to the need for more aggressive diagnostic efforts and empiric treatment for children with TB who are not cured by a first-line regimen. Maleshoane’s original doctors likely exacerbated her drug-resistance and took years away from her by subjecting her to multiple ineffective regimens with one new drug added at a time. Additionally, her initial abandonment by her mother, and their subsequent reunion, demonstrate the benefits of intensive counseling for caregivers of pediatric MDR-TB cases.

Story Collected by: Megan McLaughlin, Hind Satti, and KJ Seung (Partners In Health)