Nyein – Singapore

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

Nyein was born in Singapore in 2007 to parents originally from Burma. Nyein first began to show signs of illness in March 2008, when she was just one year old.

Nyein’s doctors were unable to isolate the bacterium that causes TB in Nyein’s sputum samples, but diagnosed her with MDRTB based on her clinical symptoms and her mother’s previous DST-confirmed diagnosis of MDR-TB that was smear-positive (meaning contagious). Nyein’s mother’s strain of TB was resistant to isoniazid and streptomycin.

Nyein was hospitalized for the first six months of her treatment due to persistently low levels of both red and white blood cells. While she was in the hospital, nurses administered Nyein’s daily MDR-TB treatments.

Throughout Nyein’s treatment she suffered from multiple intracranial hemorrhages (bleeding in her brain), Candida septicemia (blood poisoning caused by a yeast-like fungus which inhabits the intestines), and severe pneumonia, which resulted in acute respiratory distress syndrome.

After six months in the hospital, Nyein was discharged to the care of her parents. Nyein’s mother was experienced in MDR-TB treatment, as she was receiving treatment at the same time, and understood the importance of strict treatment compliance for Nyein at home.

Nyein successfully completed one year of MDR-TB treatment, and at her last clinical visit review, in June 2011, was cheerful, active, and developing normally. Since then, Nyein and her parents have moved back to Burma.

Story Collected by: Koh Pei Lin, MD, Department of Pediatrics, National University Hospital, Singapore