Compromised immune systems

Aids-related deaths in South Africa: 2 438 978 at noon on April 2

Becky Mugisha* had been ill with a hacking cough for three months before she was admitted into one of Kampala’s tuberculosis (TB) wards. It was her second bout with the disease.

As a person living with HIV, she was used to taking multiple pills on a daily basis, but she failed to complete her treatment during her first bout of TB because the clinic where she lives in Wakiso, east of Uganda’s capital, Kampala, ran out of the drugs.

Mugisha’s compromised immune system and treatment history made her susceptible to infection with multi-drug resistant TB. Now Mugisha is receiving in-patient treatment at the TB unit in Mulago Hospital, Kampala.

According to the 2008 global tuberculosis report, released by the WHO this week, Uganda has the lowest TB cure rate in the world—just 32%. The report also notes that in 2004 and 2005, Uganda had the highest default rate (numbers of patients who fail to complete treatment) of all countries with large TB burdens.

While more than half of Uganda’s population may carry a latent form of TB, people with HIV-compromised immune systems are 50 times more likely to develop an active TB infection. TB is the most common opportunistic infection for people living with HIV and accounts for up to half of Aids-related deaths worldwide.

About half of the patients at Mulago Hospital’s TB unit are HIV-positive, said Dr Alphone Okwera, who heads the unit.

* Not her real name

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