Paki – South Africa

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

In early 2008, Paki, just five years old, developed a severe deformity of his spine. He was referred to a hospital in Cape Town, where a scan revealed a large, infected abscess. Despite Paki’s not having known contact with anyone with the disease, his doctors wisely suspected TB and started him on first-line anti-TB treatment. After staying in the hospital for two months, Paki could finally return home to finish his treatment.

But months after Paki returned home, his spine was worsening. Returning to the hospital, he had a second scan. The abscess had worsened, and Paki’s spinal deformity had become more pronounced. Again his parents said that there had been no contact with anyone with TB. A further drug was added to his treatment, but one month later, his spine had deteriorated still further. Six-year-old Paki underwent surgery.

The surgeons removed the infected area and fused a number of the vertebrae together. The laboratory detected TB bacteria in the removed samples, but they could not perform testing for drug resistance because the bacteria wouldn’t grow in the lab. Paki’s doctors continued to monitor him, and after seeing his condition worsen a month later, started him on treatment for MDR-TB. Each day, Paki had to have an injection and take seven tablets. He also had to have a second operation to further decompress and straighten his spine.

After a few days, it was discovered that Paki’s family member and former caregiver had been diagnosed with MDR-TB of the lung in 2008. Paki was transferred to the regional drug-resistant TB hospital, where he remained for six months, receiving daily injections. He also had to have regular blood tests to monitor the functioning of his kidneys and thyroid, as well as audiology testing to monitor his hearing (commonly damaged by second-line anti-TB drugs). Finally, Paki returned home, where he continued his grueling treatment for an additional year. Paki finished his treatment and is clinically very well, but his deformed spine bears witness to his struggle against DR-TB.

Story Collected by: Simon Schaaf and James Seddon (Desmond Tutu TB Centre)

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