Saving Baby Mary's Life: Learning to Diagnose TB Early and Accurately in South Sudan

 {Photo Credit: Males Emmanuel/MSH}Baby Mary after two successful weeks on anti-TB treatmentPhoto Credit: Males Emmanuel/MSH

At nine months old, Mary Yeno had lived with TB for nearly half of her short life before being accurately diagnosed and treated.

Mary’s mother, Flora Faida, carried the baby to three different health facilities without success.

“She was coughing and had difficulty breathing. She stopped breastfeeding,” Faida said.

Faida and her husband David are farmers in Kenyi village in South Sudan’s Central Equatoria State. Their livelihood grew more precarious when baby Mary fell sick in August 2015. Faida used her savings to pay for treatment, but the health workers they saw never suspected TB.

While adults can be diagnosed routinely by sputum examination, infants and children with TB are often misdiagnosed, as TB can mimic nearly any other disease. Few health workers in rural facilities have been trained in pediatric TB.

In January 2016, Faida brought her daughter to Yei Hospital. There, in the TB Management Unit, nurse Loise Nyoka finally diagnosed Mary with TB, using a diagnostic score chart. The score chart presents questions about family history of TB, coughing, breastfeeding, and malnutrition. The answers revealed that Mary had TB; she was also severely malnourished.

The USAID-funded Challenge TB project, led by MSH, had equipped health workers at Yei and other hospitals with the skills and tools to diagnose and treat TB in all age groups.

Challenge TB continues to mentor health workers in Central Equatoria on contact investigation, diagnosis, and treatment. In 2015, the project mentored 40 clinicians and nurses in a variety of facilities.

Meanwhile, health workers at the hospital screened Mary’s parents. David Faida, it turned out, had been coughing for two years. He was diagnosed with TB in November 2015 and was immediately enrolled in treatment.

“I came to realize that my daughter got TB from me,” said David Faida. “I thank the nurses for diagnosing the sickness that has been affecting my family.”

As he began treatment, his daughter was already recovering. After two weeks of medication and therapeutic feeding, Mary was discharged from Yei Hospital to finish her regimen back at home.