Spinal TB: A living hell

By Sharon Kavhu

BULAWAYO-MELODY Hlazo, 38, suffers from spinal tuberculosis (TB), a rare type of multidrug-resistant tuberculosis (MDR TB).

She was diagnosed with the infection early this year at Mpilo Hospital in Zimbabwe’s second city where she was initiated on treatment in February.

Hlazo is now a permanent resident at an infection control hospital, Thorngrove Isolated Hospital.

“I’m paralysed from the waist down,” said Hlazo, speaking to MPs during a tour of the                   TB health facilities at the hospital.

“Whenever I feel like turning my body to face the other side, I can only do it with the help of someone,” she said.

Her skin clings to her bones, evidence that she had lost a lot of weight. Her condition could have been worsened by her suppressed immune system since she is living with HIV.

Hlazo, together with her last born, tested HIV-positive in 2009 and they were placed on Anti-Retroviral Treatment (ART).

In 2014, she lost her husband to TB and HIV.

Hlazo, a mother of three, said her condition started off as a seasonal ailment and eventually worsened to paralysis.

“Sometime last year, I started having back pains and seasonal mild pains in the knee and hip joints. I used to just go to the clinics to get pain killers,” she remembers.

Her life changed though when, while visiting her father, she started feeling numb in both her legs. She could not move.

“It scared me a lot that at some point I thought I was bewitched. They rushed me to Mpilo General Hospital and an X-ray determined that I had Spinal TB.

“I was initiated on TB treatment in February this year but I was not adhering to treatment because the pills used to make me puke after every meal. The same pills also made me lose appetite.

“Even now when I take the TB drugs, I feel like they are damaging my tongue. I really don’t like the medication even though I know it makes me feel better.

“Through the medication that I have been taking, I have seen some improvements on my paralysis. Initially, I could not feel my legs; even if someone pinched me. I couldn’t feel any sensation.

“However, now I can actually feel something when someone touches me.”

The condition has also come with memory loss for her, she said.

Sadly, her abdomen has developed deep sores which doctors are attributing to staying in the same position for a long time.

Dr Menace Ncube, the medical officer of Bulawayo City Health at Thorngrove Isolated Hospital, said Spinal TB is more likely to develop in people who have a suppressed immune system.

“Unlike Lung TB which has risk factors such as smoking, exposure to a lot of dust, Spinal TB’s risk factors are anything that causes suppression of the immune system in the body.

“It can be HIV, diabetes, old age or taking medication               that weakens the immune system.

“As you may know, TB can affect virtually any part of the body but the root of infection is generally the same as through the lung.

“If it stays in the lungs, it is called TB of the lungs but it may spread to other parts of the body such as the bones, brain and so on.

“Amongst those areas, it can also go to the spine and the infection will be called spinal TB. In terms of treatment, TB treatment is the same and it does not matter where the TB will be manifesting, the only difference is the duration.

“Spinal TB treatment takes longer than the Lung TB because, the medicines take longer to reach the spine than it takes to reach the lungs.”

He said ordinary treatment for Lung TB generally takes six months whereas with Spinal TB it takes eight months for adults and children ten months or even a year or more.

Dr Christopher Zishiri, the country director for The Union, an international voluntary scientific organisation, said they have been training Zimbabwean health professionals on care and treatment for TB patients.

“The spinal TB is very slow in developing and may take time before diagnosis compared to the pulmonary TB. This type of TB is debilitating,” said Dr Zishiri.

He said spinal TB affects the spine and has no association with memory loss but spinal deformities.

According to the organisation TB Alert, there were 21 deaths daily from TB in Zimbabwe in 2014.