Full of Hope: Shorter Treatments, Faster Recovery for TB Patients in Bangladesh
Living with TB is very hard, and living with drug-resistant TB (DR-TB) is even worse. The drugs needed to treat DR-TB are not only toxic but also very expensive, and treatment can take as long as two years to complete. In April 2017, with the support of USAID’s Challenge TB (CTB) project, Bangladesh started its first patients on a shorter treatment regimen for DR-TB. This new treatment takes less than half the time to complete and is less expensive than the traditional treatment, making it much less of a burden on both patients and the health care system.
Billal was one of the first two patients put on this new treatment. This is his story, in his own words.
"I have been a diabetic for several years now, and I have to take insulin every day. A year or so ago, I started having a high fever and cough, and when I went to the doctor for my regular check-up, he thought I might have TB. He told me that if you have diabetes, you are much more likely to get TB than someone who doesn’t. My doctor did a chest X-ray to confirm his diagnosis, and they sent me home with some medication.
After taking the medication for a while, I found I wasn’t improving. Every time I coughed, it felt like my body was breaking. It was difficult to breathe.
So I went back to my doctor, and he decided to send me to the health center in Comilla district to be tested for drug-resistant TB. After two days the results came back saying I had multidrug-resistant TB.
When I heard the result, I thought ‘I am going to die’, and I told my brother as much. But I was sent to the Institute of Diseases of the Chest and Hospital [NIDCH] in Dhaka to receive specialized treatment. There a doctor who was working with the Challenge TB project gave me counseling, something that continued throughout my treatment and was vital for my recovery.
I have my wife, two sons, and a daughter. When I started treatment, I said goodbye to my children and said to them that if God favored it, I would make it and we would be back together soon. I asked them all to pray for my recovery.
During my treatment, my children were unable to visit, mostly because the cost of transport was too high, but also because my sons were busy with their studies and my daughter was being looked after by my sister. Thankfully we were able to talk on the phone, and I was able to hear that they were doing fine and to reassure them that my treatment was going well.
I stayed at the NIDCH for two months and seventeen days, with my wife attending to all my needs. Life in the hospital was very difficult for both of us, my wife had to sleep on the floor, and I found it hard to eat because of my diabetes and because the drugs caused me to vomit and experience abdominal pain. For a while, I had a sustained buzzing in my ears caused by the drugs, but thankfully it gradually subsided.
I heard that in the past patients had to stay in the hospital for at least for six months and the whole treatment took more than two years. Now the treatment period is shorter, and after two months I was able to go home. For the remaining seven months I was treated close to my home.
I can only imagine what it would have been like being on treatment for two years and how much it would have cost. Luckily my medical care was free, but I still had to provide for my family. I had to rely on the help and support of others, and I borrowed money from my sisters and neighbors.
After completing the full nine months of treatment, I feel much better, and I am regaining my strength. I still have to rely on the support of others, and my son earns money by tutoring younger students in Bengali, English, and mathematics. When I feel strong enough, I sometimes work as a day laborer.
Here I am today, healthy, happy, and full of hope. I am indebted to the Challenge TB team who helped me to win the fight against this terrible disease and to return to my family and my normal life."
CTB is challenging the scourge of TB in Bangladesh by providing shorter regimens and supporting patients through the difficult process of treatment. Between April and June 2018, 614 DR-TB patients started on treatment at the NIDCH. Of these, 516 patients were enrolled on the shorter treatment regimen, 255 of whom had been discharged from the hospital by the end of June 2018 to continue their treatment in the community.