Tajikistan: Children with multidrug-resistant tuberculosis can be cured

Swedish doctor Ann Åkesson spent six months as medical team leader in MSF’s project in Dushanbe, which focuses on children and young people with multidrug-resistant tuberculosis (MDR-TB).

Tajikistan: Children with multidrug-resistant tuberculosis can be cured



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Although treatment for the disease is long, painful and complicated, MSF has shown that young people with MDR-TB can be cured.

Why did MSF open a project in Dushanbe?

“Before 2011, when MSF opened its project in Tajikistan, there was no treatment available for children suffering from multidrug-resistant tuberculosis (MDR-TB). Our aim is to create a model for effectively diagnosing and treating children with the disease. We want to show that it is possible to treat even small children. To give children the right dose, we have had to produce medicines in liquid form ourselves, using the pills made for adults.”

How do you treat MDR-TB?

“The drugs to treat MDR-TB are less effective than those for treating drug-sensitive forms of the disease. Patients need to take much more medication over a far longer period of time – two years usually – and patients must receive daily painful injections for the first year. The drugs also have serious side effects, including nausea and even hearing loss. We try to reduce the side effects as much as possible, but sometimes, to safe the life of a child, we need to continue to give them a drug that can lead to numbness. We have no choice, there is no better medicine available.”

How do children catch MDR-TB?

“Often children get infected by their parents or older siblings who have MDR-TB but don’t know it. Drug-resistance can also develop if a patient does not take their medication regularly. This is why it is so important that children take all of their medication, every day without fail, throughout the treatment period. This can be difficult, especially for young people who may be rebellious and refuse to take their medication. You need to constantly explain to them how important it is that they continue with their treatment, even if they are experiencing severe side effects. We have specially trained staff who provide treatment support to children and their families.”

Is there a patient whose story particularly affected you?

“We had a 14-year-old girl in our programme with extensively drug-resistant TB (XDR-TB), which is a very resistant form of the disease. She couldn‘t mix with the other children because of the risk of infecting them. She was very lonely. Her mother had died of MDR-TB and her father was homeless. When we came to work in the mornings, she’d be sitting at her bedroom window staring out into the yard. She was very ill and had already been through many courses of treatment when she came to us. Our team struggled for a long time to save her. It was very sad when she died. Afterwards, whenever I passed by, I always looked up at her window.”

What about the other children’s chances?

“Most children can be completely cured of MDR-TB. Each time a child finished treatment, we had a small ceremony to celebrate him or her being healthy again. The patient received presents and a diploma for having held out so bravely. Then we’d have music and dancing.”

20 March 2014
Interview by Sonja Leister / MSF Sweden.