YOU (South Africa)
How two doctors fought TB, plus what do if you’re worried
Married medics Arne and Dalene von Delft are using their personal experience of TB to raise awareness of the illness
JUST like medical student and Miss SA Tamaryn Green, they faced occupational risks when dealing with infected patients. Several of the people they cared for had tuberculosis (TB) but the couple weren’t really worried that they were at risk of contracting the disease.
Unfortunately that’s exactly what happened to Drs Dalene and Arne von Delft.
Dalene (36), a general practitioner, contracted multidrug-resistant tuberculosis (MDR-TB) back in 2010, then two months later, Arne, who’s now completing his specialisation in public health, was diagnosed with a latent form of the illness.
This experience led them to become two of the seven cofounders of TB Proof, a nonprofit organisation that seeks to remove the stigma around TB.
And their message to the public is blunt: TB can happen to anyone, no matter their social standing, race, gender or occupation.
The two medics are speaking to YOU at their home in Somerset West where they live with their kids, daughter Elodie (3) and son Heinrich (1).
“I met Dalene in 2001 and although I’d told myself I’d never marry a doctor, I couldn’t help myself,” says Arne (38), glancing lovingly at his wife.
IT WASN’T the kind of Christmas she’d been expecting. Dalene was screened in December 2010 and was stunned when the radiologist called her in on Christmas Eve to say she definitely had MDR-TB. “I remember bursting into tears. I thought, ‘Oh my word. My lung is destroyed’,” she says. “I’m a really fit person and used to compete in national aerobics fitness championships. I was shattered.”
The news came as even more of a shock because she hadn’t been feeling ill. All she’d felt was an irritation in the throat, she says.
“I thought it was just hay fever, but then a colleague noticed I had a slight cough and suggested I go for an X-ray.”
At the time of the diagnosis she and Arne were working at Tygerberg Hospital in Cape Town.
They’d studied together at the University of Stellenbosch and graduated in 2006 before doing their medical internships in East London in 2007 and 2008.
“We had no training in infection control or wearing masks or anything like that, so we saw loads of TB patients but I wasn’t really worried about it too much, even though I knew I’d been exposed,” Dalene says.
She underwent a rigorous 19-month treatment that involved taking seven different antibiotics with horrible side-effects.
She was in hospital in isolation for two weeks before going home, where she had to stay in a separate room from Arne. She also wore a mask whenever she came into contact with others.
“The antibiotics would cause nausea,
diarrhoea and hair loss. It was horrible,” she said.
And there was more bad news to come: eight weeks into Dalene’s treatment Arne was diagnosed with presumed primary pleural tuberculosis – which is when patients present symptoms suggestive of TB.
“The disease couldn’t be diagnosed because they couldn’t find the actual TB and I never started TB treatment,” Arne explains. “I spent three weeks in bed and got better, but I now have a latent infection [see box right].”
It was around this time Dalene started losing her hearing. “Every time I went for an audiogram, my hearing got worse.” The medication she was taking can cause up to half of patients to become deaf.
She was devastated. “It would mean the end of my medical career because I wouldn’t be able to listen through my stethoscope.”
They then heard about a new trial drug to end drug-resistant TB from a pharmacologist friend, Dr Elsimé Kift, and Dalene ended up taking that.
It was a success and she was soon on the road to recovery although she never fully got her hearing back. “She has a mild hearing impairment at worst,” Arne says. “A very lucky outcome.”
Since 2015 Dalene has divided her time between looking after her kids and working part time at TB Proof.
Arne is the national health lab service registrar for the Western Cape department of health.
THEY’RE not 100% sure how they contracted TB but it’s likely to have been through their work. Still, the couple are acutely aware of the stigma that surrounds the disease. That’s why in 2014 TB Proof launched a campaign called #UnmaskStigma. It encouraged people to wear Zero Stigma masks in public and applaud those fighting the disease.
Dalene and Arne emphasise that while vaccinating your child is important and can help prevent TB of the brain, it may not prevent disseminated TB (which spreads from the lungs to other parts of the body).
It’s important that vaccination still be used as a precautionary action.
Adults who haven’t been vaccinated can be inoculated, but they may still get TB because the vaccinations aren’t strong.
“The most common symptoms of TB are night sweats, coughing, unexplained weight loss, fatigue, fever and poor growth in children,” Arne says.
Because TB can move from your lungs and infect any other part of your body and in rare cases can cause women to become sterile, there’s an added stigma attached to the disease, Dalene adds.
Luckily TB can be beaten – if you have yourself checked.
For more information go to tbproof.org and unmaskstigma.org.
‘The most common symptoms of TB are night sweats, coughing, unexplained weight loss, fatigue, fever and poor growth in children’