KwaZulu-Natal, South Africa (CNN)The terror crept over Khumbulani Shandu. Lying in his hospital bed, he knew that something was very wrong. The world was rapidly closing off to him. He could hear muffled, indistinct sounds coming from doctors at the hospital in KwaZulu-Natal, South Africa, but he couldn’t quite make out what they were saying.
Just 14 years old, Khumbulani was rapidly going deaf.”I just couldn’t understand the sound. I just couldn’t understand. It was the most difficult thing in my life,” he said. Then, the sound all but stopped.
Khumbulani had contracted tuberculosis from his father at their rural homestead in 2016. But first-line drugs didn’t work, and he embarked on a painful and difficult treatment for drug-resistant TB.
For months, his doctors prescribed a highly toxic injectable antibiotic called kanamycin along with a cocktail of other drugs to attack Khumbulani’s infection.But the injectable that was meant to cure him had made him deaf. Khumbulani Shandu and his mother at their homestead in KwaZulu-Natal. Khumbulani was left deaf and partially blind because of toxic TB drugs.
Khumbulani Shandu and his mother at their homestead in KwaZulu-Natal. Khumbulani was left deaf and partially blind because of toxic TB drugs. A terrible choice Many thousands of patients with multidrug-resistant tuberculosis have had to make the horrific choice between potential deafness or death.
This level of resistance means the bacteria that cause the infection are resistant to being treated with at least two of the most powerful anti-TB drugs: isoniazid and rifampin.
For decades, the World Health Organization has recommended a select range of injectable antibiotics to treat the infection, despite studies showing that up to 60% of patients who receive them lose their hearing.
It’s a choice that nongovernmental organizations like Medecins Sans Frontieres (Doctors Without Borders) say they shouldn’t have to make. They have been campaigning for several years for the availability of safer drugs.
Now, the South African government is taking a stand. Starting this month, it will roll out a newer, less toxic drugs to all patients with drug-resistant TB, moving beyond WHO guidelines, which have yet to endorse the use of the drugs.
In making the announcement, the South African Department of Health said real-world data showed a significant increase in treatment success and far less adverse side effects for patients.
“All governments should make it possible that the patients that need this new medicine should access it. It is very important. Globally, the speed of uptake is ridiculously unacceptable.
I think we can do better,” said Dr Norbert Ndjeka, the head of South Africa’s drug-resistant TB program. A killer of the poor
There is no doubt TB is a major public health risk.
An infectious disease mostly affecting the lungs, TB can be particularly difficult to treat, and drug-resistant strains are on the increase.
South Africa’s burden of the airborne disease is particularly high, as a high incidence of HIV has worked hand in glove with drug-resistant TB, weakening immune systems to make people more susceptible.
More than 430,000 people were infected with TB in South Africa in 2016, and more than half of them were also HIV-positive. Of the 123,000 deaths from TB, 100,000 also had HIV.
Finding a voice
He says hearing aids won’t work, because the injectable agents destroy the inner workings of the cochlea.
Says his mother, who is in the room, “we have hope now.”