An expectant mother develops and is counseled for multi-drug resistant TB
By Diana Tumuhairwe
At six months pregnant, Angela Namatovu was excited. The pregnancy was going well, and she could not wait to give birth to her baby boy.
Like any careful expectant mother, when she developed a cough, she knew that the right thing to do was seek medical attention. She went to a nearby local clinic in the Simbwe, Wakiso district in central Uganda, not thinking her symptom was anything serious. The health facility could not find anything wrong but still referred her to Mulago Hospital. There, she was asked for sputum samples and was also given medication for 10 days.
When Namatovu and her husband returned to the hospital, health workers told her she had been diagnosed with multidrug-resistant TB (MDR-TB), which she had never heard of before. Her husband immediately walked out of the room; that would be the last time Namatovu saw him.
She was now alone, poor, and pregnant in a public health facility far away from home. The medications’ side effects left her feeling lifeless. Namatovu thought she was going to die.
But at the hospital, Namatovu soon met with a counselor who was part of the USAID-funded TRACK TB project, led by MSH. TRACK TB increases MDR-TB case detection and treatment success by providing medical officers, community linkage facilitators, and a counselor to hospitals. Namatovu’s counselor educated her about the disease and how to keep her baby healthy. The counselor also gave Namatovu hope about her future — which is when she realized that she could recover and her child could be protected. All she had to do was faithfully adhere to treatment and the health worker’s advice.
After Namatovu gave birth, she was given a special room in the hospital where she stayed with her baby for a month. Once she was ready to be discharged, the next hurdle was where to live. She did not know where her husband had gone, nor how to reach him. Health literacy is generally low in much of Uganda, and patients with TB, let alone MDR-TB, are brutally stigmatized. Most of Namatovu’s family also refused to have contact with her.
Upon learning of her dilemma, the TRACK TB team visited Namatovu’s sister, a recently widowed, nursing mother who also did not want to risk living with an MDR-TB patient. But the TRACK TB team counseled the sister, informing her about the disease, infection control, and directly observed treatment, the tuberculosis control strategy recommended by the World Health Organization. As a result, Namatovu’s sister agreed to take her in and now serves as her treatment supporter. Namatovu herself is faithfully complying with her treatment, and her baby is healthy and growing steadily.