Zambia faces TB Among Women With HIV

HIVJustina Banda, 44, says that because she is HIV-positive she is extra prone to tuberculosis. She has had TB three times, most recently last year.

Though she has completed her TB treatment, she says she often feels sick and is scared that she might have another relapse. She is going for a TB review in a few days.

Banda rents a one-room apartment in Kanyama, the most densely populated area west of Lusaka, the capital. She says crime, poverty and unemployment plague the area. Its residents live in tiny houses that are linked together and lack proper ventilation and access to clean water.

She shares the one room with her husband and their six children, some who are in their late teens. The tiny room with one small window is their bedroom, kitchen and living room.

Banda, who learned she had HIV two years ago, says her struggle with TB began in 1996. She underwent treatment but got it again in 1999 and 2010.

“I was told to eat a balanced diet, but hunger is part of our life,” she says.

TB is a leading cause of death among people living with HIV here, according to Justin O’Brien, policy, advocacy and communications manager for The Zambia AIDS Related Tuberculosis Project, ZAMBART, a nongovernmental organization that aims to improve the quality of life of people with HIV and TB. About 70 percent of Zambian TB patients have HIV, according to the World Health Organization.

TB levels are high among HIV patients because of their weakened immune systems, said Dr. Nathan Kapata, national TB and leprosy program manager for the Ministry of Health, in the Times of Zambia, a newspaper here. TB, caused by a germ in the lungs that can be spread when an infected person coughs or sneezes, is easily passed among people living closely together, said Kapata in the Zambia Daily Mail, another newspaper here.

Dr. Peter Chungulo of ZAMBART says that poverty and malnutrition, or undernutrition, also contribute to TB infections, whether it’s new cases or relapses.

Banda’s face looks dehydrated. She says she is weak because she can’t afford to eat three meals a day.

“Sometimes it’s a challenge to take both TB and HIV drugs on an empty stomach,” Banda says. “I struggle to eat required food for a TB patient because I don’t have any source of income.”

She knits plastic threads into a handbag, which she aims to sell to raise a few kwachas, the currency here. She used to crush stone and sell charcoal, but her doctors advised her to stop.

“I struggle to work, as I feel weak and my back pains severely,” Banda says. “My children cannot go to school because we cannot [afford] to take them to school.”