After two years of treating almost everyone in the house, we are finally clear of one of the most common diseases in the Philippines.  Here is the result of Jakei’s xray last Saturday:

Roentegenological Findings:

Compared with previous examination dated 08.14.10 shows interval decrease in the size of the enlarged tracheobronchial lymph nodes which are now calcified.
Both lungs are clear.
Heart is not enlarged.
Diaphragm and costophrenic angles are normal.

Impression:

 

Although Primary Complex is endemic in the country and about 8 out of 10 children acquire the disease, I was still distraught when my then 11-month-old daughter tested positive in her tubercullin test.  I was reassured that there was nothing to worry about as medication was available but I was also aware that tuberculosis remains to be part of the top 10 leading causes of child mortality.  Given the circumstances of my daughter’s birth, I knew that my fears were not unwarranted.

Everyone in the house had chest xrays taken to determine from whom Jade acquired the disease.  Well, being the half-mutant, half-alien that I am, I tested negative while everyone else turned out to have minimal Koch’s.  Six months hence, Jade was still not fully healed and Jakei was also diagnosed to have Primary Complex.

What exactly is Primary Complex and how is it acquired?

Primary Complex is an infection in the lungs caused by the Mycobacterium Tuberculosis.  If left untreated,  the infection can spread to other parts of the body and can lead to tuberculosis of other organs.

Children acquire the disease from adults who have active tuberculosis.  The infection can be transmitted through droplets or through the air.

What tests did we undergo?

The kids both had tubercullin skin tests and xrays.  The tubercullin skin test was done by injecting a measured amount of purified protein derivative(PPD), a TB antigen, under the top layer of the skin on the forearm.  After three days, the injection site was observed for inflammation.  The chest xrays, taken in apicolordotic view and lateral view, verified the tuberculosis.

The adults whose xrays revealed minimal Koch’s also had their sputum cultured.  Mucus samples were taken and cultured to determine if the tuberculosis was active.

What medications did we take?

The kids had three different kinds of medicine. PZA(pyrazinamide) was taken for the first two months of treatment. Rifampicin and Isoniazid were taken for one year.  The medicines were given very early in the morning as they worked best on an empty stomach and required an hour before any food could be consumed. We used Natrapharm’s Kidz Kit3 and Kidz Kit2 throughout the treatment.

The adults were given Natrapharm’s Fixcom 4 (Rifampicin + Isoniazid + Pyrazinamide + Ethambutol) for two months. Then had to take Fixcom 3 for the rest of the six-month treatment.  The amount of capsules needed to be taken daily depended on body weight.

Everyone also had to take vitamin B supplements.

Could Primary Complex be prevented?

Not really, as it is endemic in our country.  But we could take precautions so our children would not acquire it at such an early age.  One that I regret not having done early on is to require helpers to undergo medical examination before they are employed.  We have rectified this by ensuring that all helpers we employ are clear of any ailments before they are accepted into the household. It is also best to avoid taking young children to crowded places so as not to expose them to infectious diseases.