Dealing with Primary Complex
At
around 11 in the morning for the past two and a half months, our little Queen B
takes her Primary Complex medication. Last December while we were in Negros, she
was diagnosed of the disease after testing positive on a Mantoux tuberculin skin test (TST). It was further confirmed with a
chest X-ray.
Primary Complex, also known as Primary Koch’s infection, is tuberculosis infection in children. When
an adult with an active TB coughs, sneezes, spits, and even speaks, he releases
microscopic droplets that contains the bacteria that causes tuberculosis which
a child (or any other person, actually)
may inhale. Exposure does not automatically lead to infection. If infected
though, the child’s immune system will quarantine the infection site. The child
will seem healthy until his immune system drops and the disease becomes active.
There
are signs, though, that may indicate Primary Complex in children. These are:
1.
Recurrent cough
2. Feelings of sickness or weakness,
lethargy, and/or reduced playfulness
3.
Low grade fever of unknown origin
4.
Night sweats, and
5.
Failure to thrive or very slow weight and height gain
Upon
turning 8 months of age, our little Queen B’s weight gain rate slowed down to
around 0.1-kg gain per month. Since her weight and height is still in the
normal range in the age-weight-height chart of the World Health Organization
(WHO), our pediatrician as well as J and me attributed her small frame to
genetics (Despite our weight today, J and
I were actually slim children), her increasing mobility, and slow
adjustment to eating solid food. Also, I have learned that breastfed babies
tend to be smaller in frame compared to formula-fed babies. During that period,
our little Queen B rarely gets sick also.
It
was when she turned 18 months of age that she catches the cold more frequently.
We attributed it to weather since it was the rainy season. Admittedly, it was
probably our own fault that Georgina’s pediatrician didn’t think immediately of
Primary Complex as we don’t bring our little Queen B to her every time she had
the cold. Since we already have a prescription for the usual medicine for runny
nose and cough (which are
over-the-counter drugs, anyway), we give those medicines whenever our baby
got the cold. So we are really thankful
that the pediatrician in Negros thought of Primary Complex upon seeing Georgina.
Right
now, we are in second stage of the 6-months long treatment for Primary Complex.
Our little Queen B was prescribed to take 3 medicines namely Pyrazinamide (also called Zcure® Forte),
Rifampicin (also called Natricin®
Forte), and Isoniazid + Pyridoxine HCl
(also called Curazid® Forte). Together they form the Kidz Kit® Forte
Anti-tuberculosis Drug.
During
the first two months, all three were given every day. In our little Queen B’s
case, she has to drink 2.5-ml each of those three medicines. It is advised to
take the medicine in an empty stomach so she can’t have food 2 hours before and
1 hour after taking it. Also, it must be taken at around the same time every
day to be very effective. If missed, we have to start all over again. After two
months of continuous medication, the Pyrazinamide (or Zcure® Forte) was stopped
and only the remaining two will be taken until the end of the 6-month treatment
period.
Most
of the time, it will take only a little cajoling and effort to make Georgina
drink the medicine. But there are days when things got difficult (usually when she is not feeling well).
She will throw up the medicine especially right after taking the Pyrazinamide
which is the most distasteful and weird in consistency out of the three (which is why I’m glad it is only taken for 2
months). When this happens, she has to retake everything. Just to make her
swallow and keep the drugs in, we resorted to giving her marshmallows or small
bits of chocolate with the medicine as she likes them and will not spit them
out.
The Department of Health recommends the
administration of the Bacille Calmette-Guerin (BCG) vaccine to babies. It is a
vaccine against tuberculosis. Our little Queen B received hers shortly after
birth. Sadly, it is not 100% effective in preventing tuberculosis but it does
significantly reduce the complications caused by tuberculosis (if acquired) like meningitis. Since
tuberculosis is still a common disease in the Philippines, I believe it is
still advisable for our children to receive this vaccine.
I
believe that it is important for everyone to be aware that children with
Primary Complex are not contagious. They can’t infect other children so there
is no need to isolate them. They can still play and interact with other kids. We
do, however, limit her contact with people who have the cold as a precaution of
her getting infected.
Our little Queen B had fun with this impromptu play date with the kids in our neighborhood.
Since
the child may acquire Primary Complex again, it is highly recommended that all
adults who have close and prolonged interaction with the child be checked for
tuberculosis. If tested positive, the adult must undergo treatment immediately.
Good news, the adult will no longer be contagious after 2-3 weeks of continuous
medication but should still finish the treatment. DOH have an ongoing program
against tuberculosis.
Our
experience with Primary Complex has taught me the importance of an honest and
open relationship with one’s pediatrician. I know it is not practical to bring
our kids to the doctor every time they don’t feel well especially with a
disease such as the common cold. Nonetheless, knowing our children’s complete
medical history is important in helping our doctor’s detect any underlying
disease they may have. The knowledge of recurrent cough plus the slow weight
gain of our little Queen B would have immediately made our pediatrician
suspects Primary Complex. Since we still meet up with our pediatrician for our
little Queen B’s vaccine every few months, it would have been better if I had
mentioned the recurrent cough even though Georgina is already well during that
visit.
I
still struggle with patience every day but making our little Queen B take her
medicines during those days she doesn’t want them was, let’s say, like the
final exam of the test on patience. I admit there were instances I failed the
exam but with God’s grace most of the time I passed. I’m thankful for J who
even though he is already tired, remains awake to assist me.
Nowadays,
we have noticed that our little Queen B’s appetite is growing especially when
her favorite dishes like Laswa and Chicken Tinola are on the table. She will
even ask for a second serving. Albeit still slow but she is gaining weight
steadily. It will always be our goal to serve and encourage her to eat nutritious
food. Even though she still catches the cold quickly, she recovers from it
faster than before also.
Georgina likes fish and squash which are both present in that plate. Happy to say, she finished all of it.
J
and I are very grateful to our family and friends who continue to advise us and
pray for our little Queen B’s healing. We still have a long way to go before she
is completely healed from Primary Complex but with God’s grace and faithfulness
I am confident of my baby’s well-being.
#xoxo
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