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Child tuberculosis: Akello's TB preventive therapy story

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Akello, 10 years old, is living with HIV. After his mother fled to South Africa to look for work five years ago, he has been living with his auntie. As part of a research project, led by The Union, Akello has taken tuberculosis (TB) preventive treatment to reduce the risk of TB infection and improve his quality of life. This is his story told with help from his auntie, Mirembe, as Akello had gone to school for exams.

Mirembe explains: “Akello was getting fevers regularly and severe body wasting. After trying several clinics for treatment, I took him to the hospital. He was diagnosed with HIV and TB, so he started to take antiretroviral therapy (ART) and TB treatment. His life kept improving gradually over six months until he finished the TB treatment.

“The healthcare workers told me that Akello needed to take TB preventive treatment (TPT) to give him more protection from TB.

“Having seen the improvement that ART and TB treatment had made, I was confident that TPT would help, so I supported him to faithfully take the medicines over six months.

“It wasn’t easy for him to take the medicines at the start because of the number of pills he had to take, but with support from me and healthcare workers he became comfortable and his life improved eventually. He is now in a good health condition.

“In the beginning, health facility appointments were so challenging because of a lack of transport, but thankfully the healthcare workers were so flexible and only need me to take Akello to the health facility after six months.”

Mirembe did have fears about the healthcare workers visiting their home due to stigmatisation, as she didn’t want the neighbours to know Akello’s HIV status. So communication with the healthcare workers is always through the telephone and she makes visits to the health facility when Akello needs to attend an appointment.

Mirembe has always supported friends who present with signs and symptoms of TB and HIV and has encouraged, and even connected them, to the healthcare workers for screening.

Akello and Mirembe’s names have been changed to protect their identity.

The ‘Evaluation of Adherence, Completion, Events for Tuberculosis Preventive Treatment (ACE TPT) among PLHIV, including CLHIV, in Uganda’ project is exploring how TB preventive treatment can be improved for people living with HIV, including children living with HIV.