Mumbai: 6-month-old contracts MDR-TB after mother dies of same disease

Mohamed Afaan, from a poor slum-dwelling family in Wadala, is now under the care of his grandmother Naseema Shaikh. Found by field TB counsellors, the baby was admitted at Bai Jerbai Wadia Children Hospital last week.

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“His condition was very critical when we brought him to the hospital. He could not breath properly and kept crying,” said Gitanjali Rohokale, who is assisting the field counsellors in providing medical aid to the baby.

According to Shaikh, a domestic maid, her daughter Ruksana found she had TB in her sixth month of pregnancy. “She could not continue the treatment as medicines were very heavy and she was scared it would affect her pregnancy. After his birth, her condition got worse. She died within a month,” Shaikh said.

Afaan first showed symptoms when he was two months old. When his cold and cough did not cease, he was first taken to KEM Hospital where doctors said the disease got transmitted from his mother and he had weak immunity. A surgery was performed to remove excess fluid from his spine. “He underwent treatment for 25 days. There was no improvement. Instead, his weight reduced and fever continued,” Shaikh alleged.

From KEM, he was then taken to Hinduja Hospital for a series of diagnostic tests that confirmed pulmonary MDR-TB. When his health further deteriorated, Shaikh took him to JJ Hospital where a second spinal surgery was conducted to remove excess fluid. Afaan has been receiving a kanamycin injection every day along with seven other anti-TB drugs in crushed form since three months.

According to experts, drugs to treat the MDR-TB are heavy with several side effects on the patient. “He keeps crying and vomiting. The fever never goes. And he is getting thinner,” a worried father Gufran Malik said. He works at a garment shop in Dongri and manages to earn over Rs 3,000 per month. Shaikh herself manages to earn Rs 8,000 by doing household chores.

According to pediatrician Ira Shah, Afaan was put on oxygen support for two days at Wadia Hospital and all his anti-TB drugs were changed for a fresh cycle. On Monday, he was discharged to follow homecare.

Since a year, Afaan’s sister is also undergoing anti-TB medication from Sewri Hospital after she left the treatment mid-way two years ago. Dropping out of treatment made her drug resistant. She had to skip a year of schooling due to declining health last year.

The family has spent Rs 40,000 on medicines till now. “The cost of pediatric MDR-TB treatment may range between Rs 2 to 4 lakh for minimum two years. What usually delays their treatment is delay in diagnosis in children. Unfortunately, RNTCP does have specific pediatric treatment regime. It only focuses on adult treatment,” said Dr Lalitkumar Anande, chest surgeon at Sewri TB Hospital.

“What is important for pediatric TB cases is proper diet and nutrition. Medicines will do only half the job,” said Dr Avinash Patil, senior DOTS supervisor. For nutrition, Afaan is currently given only protein powder.

The family will now have to pool in money for both his and his sister’s treatment and a high-protein diet.