Think TB: My Experience With The Bacteria
By: Ndumba J KamwanyahHINDSIGHT is 20/20. In October last year my health was failing. A slew of tests turned out nothing but a pericarditis diagnosis.
Pericarditis is an accumulation of fluid around the sack-like membrane covering the heart, causing it to swell. It is a serious condition, but in my case the amount of fluid was minimal. Doctors prescribed ibuprofen to decrease the inflammation. Yet my body kept giving up on me.
Alarmed by my history of positive PPD (a TB skin test) my physician ordered another round of chest X-rays, CT scan, urine and sputum culture to rule out active TB (tuberculosis). All came back negative, again. Well, except that my CT scan and chest X-ray showed that I had two tiny nodules on my left lung.
That discovery turned out to be nothing new. This is because when I tested positive for the PPD skin test back in 2001, a chest X-ray and CT scan tests to rule out active TB showed the same nodules. Opinion varied then as to the existence of the nodules on my lung. I wasn’t worried. My physician wasn’t worried either because all my routine physical tests (including urine and sputum culture for TB) had been excellent. I relaxed, stubbornly ignoring my trusted advisor, my wife’s insistence that I follow up with the TB clinic in order to get treated for latent TB.
Positive PPD does not mean that you have an active TB. What it means is that you have been exposed to TB, and if untreated, the likelihood to develop active TB in the future is high. Therefore the medical recommendation is to get treated for latent TB.
The treatment is usually nine months of taking doses of medication. But it could also be shorter depending on the situation.
In my case, I was put on the short version of latent TB treatment. Dr Jane Carter (the head of the RISE clinic at the Miriam Hospital, in Rhode Island, USA) thinks that the nodules suggest that my latent TB at some point tried to break out in order to develop into full-blown active TB, but my immune system suppressed it. There you have it … I am a likely candidate!
The RISE clinic office in Providence, capital of Rhode Island, is a crowded and cramped space with a developing-world feel to it. But they do big things. It has a very welcoming staff with the big goal of bringing TB down to zero in Rhode Island. When discussing the side effects of the medicine, Dr Carter said that I seem stoic, meaning that I don’t complain much about my pain. It is true. Namibians (and Africans in general) are raised to be tough, and only tend to go to the hospital when we are really visibly sick. Perhaps part of it is cultural. And the other part is circumstantial – due to limited medical resources, financial reasons, and distance – forcing many to seek medical attention only as a last resort. The consequence, however, is fatal. Many have lost their lives in the process because it was too late when they decide to seek medical attention.
At the International Institute of Rhode Island where I worked with refugees, asylum-seekers and immigrants, I observed the same mentality among my fellow Africans when it comes to health issues. Some even became insulted and angry at the idea of being screened and tested for TB when they did not show any signs of being sick.
It might not mean much that I am openly writing about my TB scare moment, a matter that has nothing to do with your life. You may also find TB too prickly a matter in your life to concern you. It is a huge mistake. TB is the top killer and a public health threat in Namibia and Africa in general. According to the WHO report, Namibia has the highest TB rate in the world, second only to Swaziland. Exacerbating Namibia’s TB rate is also the prevalence of high HIV-AIDS infection, poverty and urban Namibia’s overcrowded living conditions and poorly ventilated buildings.
TB is spread and contracted through the air when people who have an active TB infection cough or sneeze … that’s what makes it a weapon of mass destruction. All it takes is for you to come in contact with the air breathed out by someone with active TB, even after that person is long gone.
Therefore, the benefit of getting screened for TB is huge. For me the thought that the air I am breathing out is not a danger to my own life, family or the person next to me is very liberating. Get screened for TB. Do it for yourself, your children, family, friends, community, and Namibia.
*Ndumba J Kamwanyah is a public policy consultant and an Africa blogger for the Foreign Policy Association. ndumba.kamwanyah@umb.edu; Twitter@ndumbakamwanyah